Saturday, February 11, 2012

Going for a Total Joint Replacement? Get decolonized of Staphylococcus aureus!

Nasal Screening for MRSA Carriage
It is well known that when one suffers a post-operative or hospital acquired infection with S. aureus (or MRSA), it is frequently from one's endogenous (own) strain. In a study recently published in Infection Control and Hospital Epidemiology, investigators evaluated the cost effectiveness of preventing staphylococcal infections in prosthetic joints by decolonization, prior to surgery, with intranasal mupirocin.

The verdict? Empirical treatment with mupirocin ointment or use of a screen-and-treat strategy before prosthetic joint implantation is a simple, safe, and cost-effective intervention that can reduce the risk of surgical site infection. 

At VCU Medical Center, we do not screen all admissions for MRSA. We do, however, screen patients for elective surgeries such as prosthetic joint implantations. If the patient is MRSA positive, then she is decolonized with mupirocin (intranasal, twice daily for 5 days) and with chlorhexidine bathing the night before and the day of the surgery. The results have been excellent.

I am off to Colorado today where I will give several lectures, over the week, at the 38th annual Winter Course.

I will be blogging, light.

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