Effectiveness of preoperative decolonization with nasal povidone iodine in Chinese patients undergoing elective orthopedic surgery: a prospective cross-sectional study

Braz J Med Biol Res. 2017 Dec 18;51(2):e6736. doi: 10.1590/1414-431X20176736.

Abstract

Staphylococcus aureus colonization in the nares of patients undergoing elective orthopedic surgery increases the potential risk of surgical site infections. Methicillin-resistant S. aureus (MRSA) has gained recognition as a pathogen that is no longer only just a hospital-acquired pathogen. Patients positive for MRSA are associated with higher rates of morbidity and mortality following infection. MRSA is commonly found in the nares, and methicillin-sensitive S. aureus (MSSA) is even more prevalent. Recently, studies have determined that screening for this pathogen prior to surgery and diminishing staphylococcal infections at the surgical site will dramatically reduce surgical site infections. A nasal mupirocin treatment is shown to significantly reduce the colonization of the pathogen. However, this treatment is expensive and is currently not available in China. Thus, in this study, we first sought to determine the prevalence of MSSA/MSRA in patients undergoing elective orthopedic surgery in northern China, and then, we treated the positive patients with a nasal povidone-iodine swab. Here, we demonstrate a successful reduction in the colonization of S. aureus. We propose that this treatment could serve as a cost-effective means of eradicating this pathogen in patients undergoing elective orthopedic surgery, which might reduce the rate of surgical site infections.

MeSH terms

  • Administration, Intranasal
  • Adult
  • Anti-Infective Agents, Local / economics
  • Anti-Infective Agents, Local / therapeutic use*
  • Antibiotic Prophylaxis / economics
  • Antibiotic Prophylaxis / methods
  • China
  • Cross-Sectional Studies
  • Elective Surgical Procedures* / economics
  • Female
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Methicillin-Resistant Staphylococcus aureus / growth & development
  • Middle Aged
  • Nasal Cavity / drug effects
  • Nasal Cavity / microbiology*
  • Orthopedic Procedures* / economics
  • Postoperative Complications / prevention & control
  • Povidone-Iodine / economics
  • Povidone-Iodine / therapeutic use*
  • Prospective Studies
  • Reproducibility of Results
  • Staphylococcal Infections / prevention & control
  • Treatment Outcome

Substances

  • Anti-Infective Agents, Local
  • Povidone-Iodine