Efficacy of preoperative screening and decolonization for staphylococcus aureus in total joint arthroplasty: A meta-analysis

Asian Journal of Surgery

Si Cheng¹  Zhen-Yong Ke²  Xiao-Lin Chen²  Yang Wang²  Dian Zhong²  Lu Lin² 

[1] Corresponding author. Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, No.76, Linjiang Road, Yuzhong District, Chongqing, 400010, China.;Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China;

关键词: Decolonization;    Screening;    Staphylococcus aureus;    Surgical site infection;    Total joint arthroplasty;   

DOI  :  

来源: DOAJ

【 摘 要 】

Summary: The purpose of this study is to conduct a meta-analysis to evaluate the efficacy of screening and decolonization protocol for Staphylococcus aureus (SA) in total joint arthroplasty (TJA). We systematically searched the electronic databases of PubMed, Embase and Cochrane databases for relevant literatures from January 2000 to September 2020. The outcomes were colonization rate, total-surgical site infection (SSI) rate, SA-SSI rate and methicillin-resistant Staphylococcus aureus (MRSA)-SSI rate. All calculations and statistical tests were performed using Stata 14.0 software. A total of 12 studies were eligible in this study. Compared with control group, the screening and decolonization group had lower risks in total-SSI (risk ratio (RR) = 0.52; 95% confidence interval (CI): 0.40–0.67), SA-SSI (RR = 0.48; 95% CI: 0.32–0.72) and MRSA-SSI (RR = 0.45; 95% CI: 0.21–0.96). The nasal SA colonization was found to be associated with higher accidences of SSI involving total-SSI (RR = 1.49; 95% CI: 1.02–2.18), SA-SSI (RR = 2.51; 95% CI: 0.97–6.50) and MRSA-SSI (RR = 7.84; 95% CI: 1.67–36.79). The colonization rate of SA was significantly reduced after decolonization. No difference was observed between universal decolonization and screening-based decolonization. In conclusion, colonization of SA is associated with increased risk of SSI in TJA. Screening and decolonization protocol are proven to be effective to reduce colonization of SA and present protective effects against SSI in TJA. Moreover, universal decolonization protocol is non-inferior to screening-based decolonization.

【 授权许可】

Unknown