1887

Abstract

Despite WHO recommendations, there is currently no national screening and eradication policy for the detection of methicillin-sensitive (MSSA) in the UK prior to elective orthopaedic surgery. This study aimed to evaluate the effectiveness of current standard methicillin-resistant (MRSA) eradication therapies in the context of (both MRSA and MSSA) decolonization in an elective orthopaedic population.

A total of 100 patients awaiting joint replacement surgery who were positive for on PCR nasal screening underwent the current standard MRSA pre-operative decolonization regimen for 5 days. Prior to commencement of the eradication therapy, swabs of the anterior nares, throat and perineum were taken for culture. Further culture swabs were taken at 48–96 h following treatment, at hospital admission for surgery and at hospital discharge. Following the completion of treatment, patients were asked to provide feedback on their experience using Likert rating scales. The primary outcome of this study was clearance 48–96 h following eradication treatment.

Clearance of 48–96 h following treatment was 94 % anterior nares, 66 % throat and 88 % groin. Mean completion with nasal mupirocin was 98 %. There was no statistically significant recolonization effect between the end of the eradication treatment period and the day of surgery (>0.05) at a median time of 10 days.

Current MRSA decolonisation regimens are well tolerated and effective for MSSA decolonization for the anterior nares and groin. The decolonization effect is preserved for at least 10 days following treatment.

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2018-06-01
2024-03-28
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