TY - JOUR
T1 - Underestimation of Staphylococcus aureus (MRSA and MSSA) carriage associated with standard culturing techniques
T2 - One third of carriers missed
AU - Tsang, S. T.J.
AU - McHugh, M. P.
AU - Guerendiain, D.
AU - Gwynne, P. J.
AU - Boyd, J.
AU - Simpson, A. H. R. W.
AU - Walsh, T. S.
AU - Laurenson, I. F.
AU - Templeton, K. E.
N1 - This research was supported by the Royal College of Surgeons Edinburgh (Joint
RC SEd/Cutner Research fellowship awarded to S. T. J. Tsang), Leonardo (Selex
Medical) (Research grant awarded to T. S. Walsh), and Arthritis Research UK
(Research grant awarded to A. H. R. W. Simpson).
PY - 2018/1/12
Y1 - 2018/1/12
N2 - ObjectivesNasal carriers of Staphylococcus (S.) aureus (MRSA and MSSA)
have an increased risk for healthcare-associated infections. There are
currently limited national screening policies for the detection of S. aureus
despite the World Health Organization’s recommendations. This study
aimed to evaluate the diagnostic performance of molecular and culture
techniques in S. aureus screening, determine the cause of any
discrepancy between the diagnostic techniques, and model the potential
effect of different diagnostic techniques on S. aureus detection in orthopaedic patients.MethodsPaired nasal swabs for polymerase chain reaction (PCR) assay and culture of S. aureus were collected from a study population of 273 orthopaedic outpatients due to undergo joint arthroplasty surgery.ResultsThe prevalence of MSSA nasal colonization was found to be between 22.4% to 35.6%. The current standard direct culturing methods for detecting S. aureus
significantly underestimated the prevalence (p = 0.005), failing to
identify its presence in approximately one-third of patients undergoing
joint arthroplasty surgery.ConclusionModelling these results to national surveillance data, it was estimated that approximately 5000 to 8000 S. aureus
surgical site infections could be prevented, and approximately
$140 million to $950 million (approximately £110 million to
£760 million) saved in treatment costs annually in the United States and
United Kingdom combined, by using alternative diagnostic methods to
direct culture in preoperative S. aureus screening and eradication programmes.
AB - ObjectivesNasal carriers of Staphylococcus (S.) aureus (MRSA and MSSA)
have an increased risk for healthcare-associated infections. There are
currently limited national screening policies for the detection of S. aureus
despite the World Health Organization’s recommendations. This study
aimed to evaluate the diagnostic performance of molecular and culture
techniques in S. aureus screening, determine the cause of any
discrepancy between the diagnostic techniques, and model the potential
effect of different diagnostic techniques on S. aureus detection in orthopaedic patients.MethodsPaired nasal swabs for polymerase chain reaction (PCR) assay and culture of S. aureus were collected from a study population of 273 orthopaedic outpatients due to undergo joint arthroplasty surgery.ResultsThe prevalence of MSSA nasal colonization was found to be between 22.4% to 35.6%. The current standard direct culturing methods for detecting S. aureus
significantly underestimated the prevalence (p = 0.005), failing to
identify its presence in approximately one-third of patients undergoing
joint arthroplasty surgery.ConclusionModelling these results to national surveillance data, it was estimated that approximately 5000 to 8000 S. aureus
surgical site infections could be prevented, and approximately
$140 million to $950 million (approximately £110 million to
£760 million) saved in treatment costs annually in the United States and
United Kingdom combined, by using alternative diagnostic methods to
direct culture in preoperative S. aureus screening and eradication programmes.
KW - Periprosthetic joint infection
KW - Staphylococcus aureus
KW - Surgical site infection
UR - https://www.scopus.com/pages/publications/85040583903
U2 - 10.1302/2046-3758.71.BJR-2017-0175.R1
DO - 10.1302/2046-3758.71.BJR-2017-0175.R1
M3 - Article
AN - SCOPUS:85040583903
SN - 2046-3758
VL - 7
SP - 79
EP - 84
JO - Bone & Joint Research
JF - Bone & Joint Research
IS - 1
ER -