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Meticillin resistance in orthopaedic coagulase-negative staphylococcal infections

Ferry, T
Published in The Journal of hospital infection. 2011, vol. 79, no. 3, p. 248-53
Abstract Orthopaedic infections due to coagulase-negative staphylococci (CoNS) and meticillin-resistant strains may be increasing. We assessed secular trends of CoNS infections and factors associated with meticillin resistance by performing a 13-year retrospective cohort study of orthopaedic patients with CoNS infections from January 1995 to December 2007. Of 60 CoNS infections, 57 (95%) were implant-related. Median follow-up after end of treatment was 5.1 years (range: 2.4-13.8). During the study period, 44,237 orthopaedic procedures were performed, 21,299 (48%) with implants. The overall cumulative incidence of CoNS-associated infection was 0.14% and 0.28% for implant-related procedures. There were non-significant changes in the absolute number or cumulative incidence of CoNS infection (chi-squared test, P values for trend: 0.45 and 0.97, respectively). Forty-five episodes (75%) were due to meticillin-resistant strains. The proportion of meticillin resistance remained stable over time (P for trend: 0.65). Whereas few (4/15) meticillin-susceptible strains were associated with prior prophylaxis that covered the causative pathogen, 28/45 meticillin-resistant strains were associated with inadequate prophylaxis (P=0.03). The cumulative incidence of orthopaedic CoNS infection is low and stable in our institution and almost exclusively implant-related. The proportion of meticillin resistance among CoNS has remained stable over the last decade with a favourable clinical outcome.
Keywords AgedAnti-Bacterial Agents/pharmacologyCoagulaseCohort StudiesFemaleHospitals, UniversityHumansIncidenceMaleMethicillin/pharmacologyMethicillin ResistanceOrthopedic Procedures/adverse effectsRetrospective StudiesStaphylococcal Infections/epidemiology/microbiologyStaphylococcus/classification/drug effects/isolation & purificationSwitzerland/epidemiology
PMID: 21955452
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Research groups Chirurgie orthopédique et traumatologique (98)
Epidémiologie et contrôle de la résistance aux antibiotiques (866)
Glycopeptide résistance (28)
Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière (330)
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UCKAY, Ilker et al. Meticillin resistance in orthopaedic coagulase-negative staphylococcal infections. In: The Journal of hospital infection, 2011, vol. 79, n° 3, p. 248-53. doi: 10.1016/j.jhin.2011.06.014 https://archive-ouverte.unige.ch/unige:24826

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Deposited on : 2012-12-21

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