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Incidence and burden of Staphylococcus aureus infection after orthopedic surgeries

Published online by Cambridge University Press:  26 May 2021

Jill G. Dreyfus ,
Holly Yu ,
Elizabeth Begier ,
Julie Gayle  and
Margaret A. Olsen
Jill G. Dreyfus*
Affiliation:
Premier Applied Sciences, Premier, Charlotte, North Carolina
Holly Yu
Affiliation:
Health Economics and Outcomes Research, Pfizer, Collegeville, Pennsylvania
Elizabeth Begier
Affiliation:
Vaccine Research and Development, Pfizer, Pearl River, New York
Julie Gayle
Affiliation:
Premier Applied Sciences, Premier, Charlotte, North Carolina
Margaret A. Olsen
Affiliation:
Departments of Medicine and Surgery, Washington University School of Medicine, St Louis, Missouri (Present affiliation: Avalere [J.D.]).
*
Author for correspondence: Jill G. Dreyfus, E-mail: jilldreyfus@gmail.com
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Abstract

Objective:

To assess the 180-day incidence of Staphylococcus aureus infections following orthopedic surgeries using microbiology cultures.

Design:

Retrospective observational epidemiology study.

Setting:

National administrative hospital database.

Patients:

Adult patients with an elective admission undergoing orthopedic surgeries in the inpatient and hospital-based outpatient settings discharged between July 1, 2010, and June 30, 2015.

Methods:

Patients were identified from 181 hospitals reporting microbiology results to the Premier Healthcare Database. Orthopedic surgeries were defined using International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) procedure and current procedural terminology (CPT) codes. Microbiology cultures and ICD-9/10 diagnosis codes identified surgical site infections (SSIs), bloodstream infections (BSIs), and other infections associated postoperatively (eg, respiratory and urinary tract infections).

Results:

Among 359,268 inpatient orthopedic surgical encounters, the S. aureus infection incidence was 1.13%: SSI, 0.68%; BSI, 0.28%; and other types, 0.17%. Among 292,011 outpatient encounters, the S. aureus incidence was 0.78%: SSI, 0.55%; BSI, 0.12%; and other types, 0.11%. Methicillin-resistant S. aureus (MRSA) infections accounted for 46% and 44% in the respective settings. Plastic/hand-limb reattachment and amputation had the highest overall S. aureus incidence in both settings. S. aureus was the most commonly isolated microorganism among culture-confirmed SSIs (48.0%) and BSIs (35.0%), followed by other Enterobacteriaceae (14.0%) for SSIs and Escherichia spp (12.5%) for BSIs.

Conclusions:

These findings suggest that S. aureus infections continue to be an important contributor to the burden of postoperative infections after inpatient and outpatient orthopedic procedures.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 1 , January 2022 , pp. 64 - 71
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION: Portions of this work were presented at the at ID Week 2018 on October 5, 2018, in San Francisco, California, and at the American Academy of Orthopaedic Surgeons 2019 Meeting on March 14, 2019, in Las Vegas, Nevada.

References

Weiner, LM, Webb, AK, Limbago, B, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011–2014. Infect Control Hosp Epidemiol 2016;37:1288–1301.CrossRefGoogle Scholar
Berbari, EB, LM. UpToDate: prosthetic joint infections: epidemiology, clinical manifestations, and diagnosis. UpToDate website. https://www.uptodate.com/contents/prosthetic-joint-infection-epidemiology-clinical-manifestations-and-diagnosis. Published 2019. Accessed February 22, 2021.Google Scholar
Skogberg, K, Kontula, KSK, Jarvinen, A, Lyytikainen, O. Bloodstream infections following different types of surgery in a Finnish tertiary-care hospital, 2009–2014. J Hosp Infect 2018;99:89–93.CrossRefGoogle Scholar
Fowler, VG Jr, Justice, A, Moore, C, et al. Risk factors for hematogenous complications of intravascular catheter-associated Staphylococcus aureus bacteremia. Clin Infect Dis 2005;40:695–703.CrossRefGoogle ScholarPubMed
Segreti, J, Parvizi, J, Berbari, E, Ricks, P, Berrios-Torres, SI. Introduction to the Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for Prevention of Surgical Site Infection: prosthetic joint arthroplasty section. Surg Infect (Larchmt) 2017;18:394–400.CrossRefGoogle Scholar
Ribeiro, M, Monteiro, FJ, Ferraz, MP. Infection of orthopedic implants with emphasis on bacterial adhesion process and techniques used in studying bacterial–material interactions. Biomatter 2012;2:176–194.CrossRefGoogle ScholarPubMed
Olsen, MA, Mayfield, J, Lauryssen, C, et al. Risk factors for surgical site infection in spinal surgery. J Neurosurg 2003;98 suppl 2:149–155.Google ScholarPubMed
Marmor, S, Kerroumi, Y. Patient-specific risk factors for infection in arthroplasty procedure. Orthop Traumatol Surg Res 2016;102 suppl 1:S113–S119.CrossRefGoogle ScholarPubMed
Yi, SH, Baggs, J, Culler, SD, Berrios-Torres, SI, Jernigan, JA. Medicare reimbursement attributable to periprosthetic joint infection following primary hip and knee arthroplasty. J Arthroplasty 2015;30:931–938.CrossRefGoogle ScholarPubMed
Bernatz, JT, Tueting, JL, Anderson, PA. Thirty-day readmission rates in orthopedics: a systematic review and meta-analysis. PLoS One 2015;10(4):e0123593.CrossRefGoogle ScholarPubMed
Kurtz, S, Ong, K, Lau, E, Mowat, F, Halpern, M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007;89:780–785.CrossRefGoogle ScholarPubMed
Kurtz, SM, Lau, E, Schmier, J, Ong, KL, Zhao, K, Parvizi, J. Infection burden for hip and knee arthroplasty in the United States. J Arthroplasty 2008;23:984–991.CrossRefGoogle ScholarPubMed
Kurtz, SM, Ong, KL, Schmier, J, Zhao, K, Mowat, F, Lau, E. Primary and revision arthroplasty surgery caseloads in the United States from 1990 to 2004. J Arthroplasty 2009;24:195–203.CrossRefGoogle Scholar
Kurtz, SM, Lau, E, Watson, H, Schmier, JK, Parvizi, J. Economic burden of periprosthetic joint infection in the United States. J Arthroplasty 2012;27 suppl 8:61–65.CrossRefGoogle Scholar
Winkler, A. Treatment of chronic orthopaedic infection. EFORT Open Rev 2017;2:110–116.CrossRefGoogle ScholarPubMed
Anderson, DJ, Arduino, JM, Reed, SD, et al. Variation in the type and frequency of postoperative invasive Staphylococcus aureus infections according to type of surgical procedure. Infect Control Hosp Epidemiol 2010;31:701–709.CrossRefGoogle ScholarPubMed
Dreyfus, J, Yu, H, Begier, E, Gayle, J, Olsen, MA. Incidence of Staphylococcus aureus infections after elective surgeries in US hospitals. Clin Infect Dis 2020. doi: 10.1093/cid/ciaa913.CrossRefGoogle Scholar
Premier Healthcare Database white paper: data that informs and performs. Premier Inc website. https://products.premierinc.com/downloads/PremierHealthcareDatabaseWhitepaper.pdf. Updated July 29, 2018. Accessed February 22, 2021.Google Scholar
FAQs: Bloodstream infection (BSI) events. Centers for Disease Control and Prevention website. https://www.cdc.gov/nhsn/faqs/faq-bsi.html#q9. Published June 25, 2019. Accessed February 22, 2021.Google Scholar
National Healthcare Safety Network. Procedure-associated module: surgical site infection (ssi) event. Centers for Disease Control and Prevention website. https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf. Published 2020. Accessed February 22, 2021.Google Scholar
Arduino, JM, Kaye, KS, Reed, SD, et al. Staphylococcus aureus infections following knee and hip prosthesis insertion procedures. Antimicrob Resist Infect Control 2015;4:13.CrossRefGoogle ScholarPubMed
Edmonston, DL, Foulkes, GD. Infection rate and risk factor analysis in an orthopaedic ambulatory surgical center. J Surg Orthop Adv 2010;19:174–176.Google Scholar
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