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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 2, 249-252.
doi: 10.1302/0301-620X.91B2.21339  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Methicillin-resistant Staphylococcus aureus in orthopaedic trauma

IDENTIFICATION OF RISK FACTORS AS A STRATEGY FOR CONTROL OF INFECTION

D. T. M. Fascia, MBChB, BSc, MRCS(Eng), Senior House Officer (TR&Orth)1; A. Singanayagam, MBChB, BSc, MRCP, Junior House Officer (TR&Orth)1; and J. F. Keating, MD, FRCS(Ed), Consultant Orthopaedic Surgeon1

1 The Edinburgh Orthopaedic Trauma Unit, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.

Correspondence should be sent to Dr D. T. M. Fascia; e-mail: danielfascia{at}gmail.com

We have conducted a case-control study over a period of ten years comparing both deep infection with methicillin-resistant staphylococcus aureus (MRSA) and colonised cases with a control group.

Risk factors associated with deep infection were vascular diseases, chronic obstructive pulmonary disease, admission to a high-dependency or an intensive-care unit and open wounds. Those for colonisation were institutional care, vascular diseases and dementia. Older age was a risk factor for any MRSA infection. The length of hospital stay was dramatically increased by deep infection.

These risk factors are useful in identifying higher-risk patients who may be more susceptible to MRSA infection. A strategy of early identification and isolation may help to control its spread in trauma units.






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