Staphylococcus aureus infections following knee and hip prosthesis insertion procedures.

Journal Article (Journal Article)

BACKGROUND: Staphylococcus aureus is the most common and most important pathogen following knee and hip arthroplasty procedures. Understanding the epidemiology of invasive S. aureus infections is important to quantify this serious complication. METHODS: This nested retrospective cohort analysis included adult patients who had undergone insertion of knee or hip prostheses with clean or clean-contaminated wound class at 11 hospitals between 2003-2006. Invasive S. aureus infections, non-superficial incisional surgical site infections (SSIs) and blood stream infections (BSIs), were prospectively identified following each procedure. Prevalence rates, per 100 procedures, were estimated. RESULTS: 13,719 prosthetic knee (62%) and hip (38%) insertion procedures were performed. Of 92 invasive S. aureus infections identified, SSIs were more common (80%) than SSI and BSI (10%) or BSI alone (10%). The rate of invasive S. aureus infection/100 procedures was 0.57 [95% CI: 0.43-0.73] for knee insertion and 0.83 [95% CI: 0.61-1.08] for hip insertion. More than half (53%) were methicillin-resistant. Median time-to-onset of infection was 34 and 26 days for knee and hip insertion, respectively. Infection was associated with higher National Healthcare Safety Network risk index (p ≤ 0.0001). CONCLUSIONS: Post-operative invasive S. aureus infections were rare, but difficult-to-treat methicillin-resistant infections were relatively common. Optimizing preventative efforts may greatly reduce the healthcare burden associated with S. aureus infections.

Full Text

Duke Authors

Cited Authors

  • Arduino, JM; Kaye, KS; Reed, SD; Peter, SA; Sexton, DJ; Chen, LF; Hardy, NC; Tong, SY; Smugar, SS; Fowler, VG; Anderson, DJ

Published Date

  • 2015

Published In

Volume / Issue

  • 4 /

Start / End Page

  • 13 -

PubMed ID

  • 28428876

Pubmed Central ID

  • PMC5395892

International Standard Serial Number (ISSN)

  • 2047-2994

Digital Object Identifier (DOI)

  • 10.1186/s13756-015-0057-4


  • eng

Conference Location

  • England