SICOT-J
Preoperative Staphylococcus aureus nasal screening and decolonization for the prevention of periprosthetic joint infection in elective total joint arthroplasty: A single-center retrospective comparative study
By Cinelli V, El Motassime A, Capece G and 6 others.
Abstract
Introduction
Staphylococcus aureus is the most frequently implicated pathogen in periprosthetic joint infections (PJIs) and surgical site infections (SSIs), with nasal colonization being a well-established risk factor for their onset. Despite this association, the role of routine preoperative screening and decolonization in reducing postoperative infection rates remains debated.
Methods
This retrospective study analyzed 2,507 elective joint arthroplasty procedures performed between January 2022 and December 2024 at a single center in Italy. Starting in 2024, patients underwent nasal swab screening for methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA). Positive carriers received a decolonization protocol consisting of mupirocin nasal ointment and chlorhexidine showers in the days preceding surgery. The incidence of PJIs in this group was compared to that observed in a control cohort from 2022-2023, during which no screening or decolonization was implemented.