Surgical site infection with methicillin-resistant staphylococcus aureus after primary total hip replacement
Walls, R. J. ; Roche, S. J. ; O'Rourke, A. ; McCabe, J. P.
Walls, R. J.
Roche, S. J.
O'Rourke, A.
McCabe, J. P.
Repository DOI
Publication Date
2008-03-01
Type
Article
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Citation
Walls, R. J. Roche, S. J.; O'Rourke, A.; McCabe, J. P. (2008). Surgical site infection with methicillin-resistant staphylococcus aureus after primary total hip replacement. Journal of Bone and Joint Surgery - British Volume 90 (3), 292-298
Abstract
We have analysed the management and clinical outcome of a series of consecutive patients who had a total hip replacement and developed post-operative surgical site infection (SSI) with methicillin-resistant Staphylococcus aureus. The incidence of this infection was 1% over a period of five years. We studied SSI in 15 patients (16 infections) with a mean age of 72.7 years (53 to 81). In all, 12 of the infections occurred early and half of the infections involved the prosthesis, resulting in an increase of 11-fold in the cumulative hospital stay. Methicillin-resistant Staph. aureus was successfully eradicated in all the patients after a mean follow-up of 53.6 months (25 to 88). Superficial incisional infections resolved after antibiotic therapy alone while deep infections required multiple operative debridements. Attempted retention of the implant in early organ space infections was successful in only one of five patients. Only three patients with implant-level infections obtained a pain-free, functional prosthesis while a further three required excision arthroplasty. We have formulated a protocol of treatment which may serve as a guide in the management of these infections.
Funder
Publisher
British Editorial Society of Bone & Joint Surgery
Publisher DOI
10.1302/0301-620x.90b3.20155
Rights
Attribution-NonCommercial-NoDerivs 3.0 Ireland