Evidence map›Paper›PMID 27601492›Full record

ArticleBMJ open2016

Is it worth screening elective orthopaedic patients for carriage of Staphylococcus aureus? A part-retrospective case-control study in a Scottish hospital.

Stephanie J Dancer, Fraser Christison, Attaolah Eslami, Alberto Gregori, Roslyn Miller, Kumar Perisamy, Chris Robertson, Nick Graves

Registry-linked trialAbstract read
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In one paragraph

Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05647252 (General Skin and Nasal Decolonization With Octenisan® Set Be-fore and After Elective Orthopedic Surgery in Selected Patients at Elevated Risk for Revision Surgery and Surgical Site Infections), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05647252 phase3completednot on this mapstarted 2023, after this paper: background citation

General Skin and Nasal Decolonization With Octenisan® Set Be-fore and After Elective Orthopedic Surgery in Selected Patients at Elevated Risk for Revision Surgery and Surgical Site Infections

TypeinterventionalSponsorBalgrist University HospitalRan2023 to 2025Enrolled1,086ConditionsElective Surgery, High Risk, Prevention of Surgical Site Infections, Randomized-controlled TrialArmsWhole Body and nasal decolonization with octenidin (Octenisan Set), Questionnaire for study participants immediately after the decolonization
3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Stephanie J DancerDepartment of Microbiology, Hairmyres Hospital, NHS Lanarkshire, Glasgow, UK.
Fraser ChristisonDepartment of Microbiology, Hairmyres Hospital, NHS Lanarkshire, Glasgow, UK.
Attaolah EslamiDepartment of Orthopaedics, Hairmyres Hospital, NHS Lanarkshire, Glasgow, UK.
Alberto GregoriDepartment of Orthopaedics, Hairmyres Hospital, NHS Lanarkshire, Glasgow, UK.
Roslyn MillerDepartment of Orthopaedics, Hairmyres Hospital, NHS Lanarkshire, Glasgow, UK.
Kumar PerisamyDepartment of Orthopaedics, Hairmyres Hospital, NHS Lanarkshire, Glasgow, UK.
Chris RobertsonDepartment of Mathematics and Statistics, University of Strathclyde, Glasgow, UK Health Protection Scotland, Glasgow, UK International Prevention Research Institute, Lyon, France.
Nick GravesInstitute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWith recent focus on methicillin-resistant Staphylococcus aureus (MRSA) screening, methicillin-susceptible S. aureus (MSSA) has been overlooked. MSSA infections are costly and debilitating in orthopaedic surgery.

methodsWe broadened MRSA screening to include MSSA for elective orthopaedic patients. Preoperative decolonisation was offered if appropriate. Elective and trauma patients were audited for staphylococcal infection during 2 6-month periods (A: January to June 2013 MRSA screening; B: January to June 2014 MRSA and MSSA screening). Trauma patients are not screened presurgery and provided a control. MSSA screening costs of a modelled cohort of 500 elective patients were offset by changes in number and costs of MSSA infections to demonstrate the change in total health service costs.

findingsTrauma patients showed similar infection rates during both periods (p=1). In period A, 4 (1.72%) and 15 (6.47%) of 232 elective patients suffered superficial and deep MSSA infections, respectively, with 6 superficial (2%) and 1 deep (0.3%) infection among 307 elective patients during period B. For any MSSA infection, risk ratios were 0.95 (95% CI 0.41 to 2.23) for trauma and 0.28 (95% CI 0.12 to 0.65) for elective patients (period B vs period A). For deep MSSA infections, risk ratios were 0.58 (95% CI 0.20 to 1.67) for trauma and 0.05 (95% CI 0.01 to 0.36) for elective patients (p=0.011). There were 29.12 fewer deep infections in the modelled cohort of 500 patients, with a cost reduction of £831 678 for 500 patients screened.

conclusionsMSSA screening for elective orthopaedic patients may reduce the risk of deep postoperative MSSA infection with associated cost-benefits.

Indexed as

Orthopedic ProceduresCarrier StateCase-Control StudiesCost-Benefit AnalysisElective Surgical ProceduresFemaleHealth Care CostsHospital Bed Capacity, 500 and overHumansLogistic ModelsMaleMass ScreeningMethicillin-Resistant Staphylococcus aureusPostoperative ComplicationsPreoperative CareRetrospective StudiesBACTERIOLOGY

Identifiers

PMID27601492
PMCPMC5020861

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.