Logo of The Journal of Bone & Joint Surgery (Br)
Quick search:        
          Advanced Search
Guest Access | Sign In
Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 9, 1256-1258.
doi: 10.1302/0301-620X.87B9.15685  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Further opinion
Right arrow FrenchSpanishGermanItalianRomanianPolishRussianCzech
Right arrow Submit a response
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow My Folders
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via ISI Web of Science (3)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Al-Maiyah, M.
Right arrow Articles by Gregg, P. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Al-Maiyah, M.
Right arrow Articles by Gregg, P. J.

Bacterial contaminants and antibiotic prophylaxis in total hip arthroplasty

M. Al-Maiyah, FRCS, FICMS, MSc, Specialist Registrar in Trauma and Orthopaedics1; D. Hill, MRCS(Path), Consultant Microbiology1; A. Bajwa, MRCS, MSc, Specialist Registrar in Trauma and Orthopaedics1; S. Slater, BSc(Hons), Research Assistant1; P. Patil, MRCS, Senior House Officer in Trauma and Orthopaedics1; A. Port, FRCS(Orth), Consultant in Trauma and Orthopaedics1; and P. J. Gregg, FRCS, Professor of Trauma and Orthopaedics1

1 James Cook University Hospital, Middlesbrough, TS4 3BW, UK.

Correspondence should be sent to Mr M. Al-Maiyah c/o Mr A. Port’s secretary, Orthopaedic Department, James Cook University Hospital, Middlesbrough TS4 3BW, UK; e-mail: mamaiyah{at}yahoo.co.uk

We have investigated the contaminating bacteria in primary hip arthroplasty and their sensitivity to the prophylactic antibiotics currently in use. Impressions (627) of the gloved hands of the surgical team in 50 total hip arthroplasties were obtained on blood agar. The gloves were changed after draping, at intervals of 20 minutes thereafter, and before using cement. Changes were also undertaken whenever a visible puncture was detected. The culture plates were incubated at 37°C for 48 hours. Isolates were identified and tested for sensitivity to flucloxacillin, which is a recognised indicator of sensitivity to cefuroxime. They were also tested against other agents depending upon their appearance on Gram staining.

We found contamination in 57 (9%) impressions and 106 bacterial isolates. Coagulase-negative staphylococci were seen most frequently (68.9%), but we also isolated Micrococcus (12.3%), diphtheroids (9.4%), Staphylococcus aureus (6.6%) and Escherichia coli (0.9%). Of the coagulase-negative staphylococci, only 52.1% were sensitive to flucloxacillin and therefore to cefuroxime. We believe that it is now appropriate to review the relevance of prophylaxis with cefuroxime and to consider the use of other agents.




eLetters:

Read all eLetters

Antibiotic for hip arthroplasty
Harish V Kurup
J Bone Joint Surg Br Online, 15 Nov 2005 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General