Surgical site infection prevention bundles may reduce S. aureus rates after TJA
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Key takeaways:
- A surgical site infection prevention bundle may reduce rates of deep incisional or organ space S. aureus after total joint arthroplasty.
- A prevention bundle may not reduce S. aureus rates after cardiac surgery.
Published results showed implementation of a surgical site infection prevention bundle may decrease rates of deep incisional or organ space Staphylococcus aureus surgical site infections after total joint arthroplasty.
“The findings of this study suggest that implementation of a [surgical site infection] SSI prevention bundle with facility-level discretion on its components may be associated with decreased deep incisional or organ space S. aureus SSI after total joint arthroplasty, but further research is needed to investigate this association outside of randomized trial settings,” Hiroyuki Suzuki, MD, MSCI, from the Iowa City Veterans Affairs Health Care System and the department of internal medicine at the University of Iowa Carver College of Medicine, and colleagues wrote in the study.
Suzuki and colleagues performed a quality improvement study to evaluate the association between implementing an SSI prevention bundle and rates of S. aureus deep incisional or organ space SSIs after cardiac surgery or TJA utilizing data from 23,005 surgical procedures at 11 Veterans Administration hospitals.
Among the 23,005 surgical procedures, researchers detected 95 S. aureus deep incisional or organ site SSIs.
Although a generalized estimating equation multivariable logistic regression model suggested a significant association between the implementation of an SSI prevention bundle and decreased rates of S. aureus SSIs after TJA, researchers found an interrupted time-series multivariable logistic regression model did not show statistical significance.
Meanwhile, researchers found no statistically significant associations between the implementation of an SSI prevention bundle and decreased rates of S. aureus SSIs after cardiac surgery.
“Based on the best existing data, a targeted bundled approach with S. aureus screening, nasal decolonization and use of the most appropriate perioperative antibiotic based on screening result (cefazolin for methicillin-susceptible S. aureus and vancomycin plus cefazolin for methicillin-resistant S. aureus) may be the optimal strategy to decrease S. aureus SSI, in combination with chlorhexidine gluconate bathing,” Suzuki and colleagues wrote in the study.
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Suzuki H, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2023.24516.
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