Is methicillin-resistant staphylococcus aureus screening necessary before Elective Joint Replacement Surgery?

Abstract

Introduction: Surgical site infection (SSI) after total joint arthroplasty can be a disastrous complication. Recently there is an increase in incidence of methicillin-resistant Staphylococcus aureus (MRSA) carrier in the community. This study aimed to determine the incidence of MRSA carrier of patients undergoing elective total joint arthroplasty in a single institution and its impact on SSI. Materials and Methods: Since 2011, nasal swab for MRSA status was taken for all patients undergoing elective total joint arthroplasty. The demographic data, the need of long-term institutional care, history of hospitalisation within 1 year before surgery and length of stay, history of diabetes mellitus (DM) and rheumatoid arthritis (RA), duration of surgery, and any infection were collected. Results: From 2011 to 2012, 444 elective total joint arthroplasties were performed in 404 patients. Their mean age at surgery was 70 (range, 18-89) years. The incidence of MRSA carrier was 0.5%. The carriers had no history of long-term institutional care, DM or RA. One carrier had a history of hospitalisation within 1 year. The incidence of SSI was 1.1% (5/444). None of them suffered from MRSA infection. Discussion and Conclusion: The contribution of MRSA carrier status to SSI after elective total joint arthroplasty is questionable. Still, we need to alert the increasing trend of MRSA carriers in the community and its potential impact on SSI.