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Journal of Bone and Joint Surgery - British Volume, Vol 86-B, Issue 2, 266-268.
doi: 10.1302/0301-620X.86B2.14129  
Copyright © 2004 by British Editorial Society of Bone and Joint Surgery
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Infection in total joint replacements

WHY WE SCREEN MRSA WHEN MRSE IS THE PROBLEM?

S. S. Mohanty, MB BS MS Orth, FRCS Ed, Associate Clinical Professor

Department of Orthopaedics, King Edward Memorial Hospital, Parel, Bombay 400 012, India.

P. R. Kay, FRCS, Consultant Orthopaedic Surgeon

Centre for Hip Surgery, Wrightington Hospital for Joint Diseases, Hall Lane, Appley Bridge, Wigan WN6, 9EP, UK.

Correspondence should be sent to Mr S. S. Mohanty.

A retrospective review of MRSA screening showed that of a total of 8911 patients screened pre-operatively between May 1996 and February 2001, 83 (0.9%) had MRSA isolated from one source or another. During the same period, 115 (13.6%) of 844 positive tissue samples taken during surgery grew Staphylococcus aureus. Of these only 1 (0.01%) was reported to be methicillin-resistant (MRSA). However, a total of 366 (43.4%) isolates from tissue samples were reported as coagulase-negative staphylococci (C-NS). Of these, 312 samples were tested for methicillin sensitivity, of which 172 (55.1%) were found to be resistant.

Staphylococcus epidermidis is the most prevalent and persistent species found on most skin and mucous membranes, constituting 65% to 90% of all staphylococci. Most isolates in tissue samples were found to be methicillin-resistant coagulase-negative staphylococcus (55.1%). Hence, it may be appropriate to undertake screening for methicillin-resistant Staphylococcus epidermidis in addition to that for MRSA.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General