Staphylococcus aureus Colonization in Patients Undergoing Total Hip or Knee Arthroplasty and Costeffectiveness of Decolonization Programme

Abstract

Background: Periprosthetic joint infection is a devastating complication of total joint arthroplasty. It seems that the<br />patient's skin, nose, throat, and urine are important sites for microbial colonization. Colonization with staphylococcus<br />aureus, especially methicillin resistant increases the risk of periprosthetic joint infection. The aim of this study was to<br />assess the prevalence of staphylococcus aureus colonization in patients candidate for arthroplasty in central Iran as<br />well as cost-effectiveness of decolonization program for prevention of post-arthroplasty infection.<br />Methods: A total of 226 patient candidates for total joint arthroplasty were enrolled in this prospective cross-sectional<br />study between January 2014 and January 2016. Specimens from nose, throat, groin skin, and urine were sent for<br />bacteriologic culture and sensitivity test. Analysis cost-effectiveness was then performed for decolonization programme.<br />Results: Patients had positive cultures from nose (15.9%), throat (4.4%), groin skin (3.1%), and urine (0.9%). In<br />general, 20.8% of the patients had positive cultures for staphylococcus aureus, among whom, 1.8% were methicillin<br />resistant. Based on cost-effectiveness analysis, decolonization program leads to 80% reduction in costs.<br />Conclusion: According to our results, although colonization with methicillin sensitive staphylococcus aureus in patients<br />undergoing hip or knee arthroplasty is lower than other studies but colonization with methicillin resistant staphylococcus<br />aureus is similar to others. Also, decolonization programme in these patients was found to be very cost-effective.<br />Level of evidence: II