Preoperative Screening And Preparation Of Patients For Orthopedic Surgery

Abstract

Introduction: Staphylococcus aureus is a major pathogen implicated in orthopedic infections worldwide. Preoperative decolonization has been promoted but different strategies present mixed results. Staphylococcus aureus (S. aureus) is an independent risk factor for orthopedic surgical site infection (SSI).We studied whether or not local treatment with bacteriophage could eliminate nasal colonization with S. aureus.

Materials and Methods: A total of 696 patients were screened for S. aureus nasal colonization between 2017– 2021 at a single institution. There were 23% (159 patients) initially S. aureus colonization preoperatively. They were decolonized with various medications: I group – with Mupirocin 35% (56), II group- with bacteriophage 65% - (103). In the II group Pyo bacteriophage were including 32% (33) and Staphylococcal bacteriophage 68% (70).After treatment, bacteriological control was done post- decolonization on the 5th -8 th days. MSSA persisted in 4% (7).Five patient who was persistently colonized for MSSA was not compliant with the decolonization protocol. There were 2 patients who had undergone decolonization and were persistently positive for MSSA at the time of surgery.

Results: Decolonization of orthopedic surgical patients using the bacteriophage intro nasal is a practical and effective regimen for reducing MSSA and MRSA surgical site infections, treatment processes was without any post-decolonization complications.

Conclusion: We hope the bacteriophage will be successfully used in the practice of decolonization S. aureus and this therapy will be reduce the resistant S. aureus to mupirocin.