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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(05): 726-733
DOI: 10.1055/s-0041-1735546
Artigo Original
Infectologia

Pre-operative Colonization by Staphylococcus aureus and Cephalosporin Non-susceptible Bacteria in Patients with Proximal Femoral Fractures[*]

Article in several languages: português | English
Leonardo R. Bastos 
1   Seção de Ortopedia e Traumatologia, Hospital Geral de Fortaleza/Exército Brasileiro, Fortaleza, CE, Brasil
2   Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
,
Mila M. Almeida 
2   Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
,
Elizabeth A. Marques 
2   Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
,
Robson Souza Leão 
2   Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
3   Laboratórios de Bacteriologia e Micobactérias, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
› Author Affiliations Sources of Funding The present work was funded by the Instituto Nacional de Pesquisa em Resistência Antimicrobiana - Brazil (INPRA, in the Portuguese acronym), CNPq 465718/2014-0, FAPERGS 17/2551-0000514-7. The present study was also partially supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brasil (CAPES, in the Portuguese acronym), Finance Code 001.
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Abstract

Objective To estimate the frequency of Staphylococcus aureus and cephalosporin nonsusceptible bacteria colonization in patients with proximal femoral fracture during preoperative hospitalization.

Methods Prevalence and incidence assessment in 63 hospitalized patients over 1 year. The median time of pretreatment hospitalization was 12 days. Samples were collected from the nostrils, groin skin and anal mucosa during the pretreatment hospitalization and were tested by the disc-diffusion technique.

Results The hospital colonization incidence and the prevalence of positive results were 14.3 and 44.4% for S. aureus; 3.2 and 6.4% for meticillin-resistant S. aureus; 28.6 and 85.7% for meticillin-resistant coagulase-negative Staphylococcus; 28.6 and 61.9% for cefazolin nonsusceptible Enterobacteriaceae (KFNSE); and 20.6 and 28.6% for cefuroxime nonsusceptible Enterobacteriaceae (CXNSE). In addition, factors such as to the duration of the pretreatment hospitalization period, being non-walker before fracture, antimicrobial use, American Society of Anesthesiologists (ASA) 4 surgical risk, and previous hospitalization, were related to an increase in the incidence of hospital acquisition and prevalence of colonization by the evaluated strains. The prevalence of colonization by KFNSE was three times higher than by CXNSE on admission, and twice as high at the time of fracture treatment.

Conclusion There was a high incidence of hospital colonization and prevalence of colonization by all strains studied, which may guide the indication of prophylactic measures for infection.

Keywords

carrier state - drug resistance - Enterobacteriaceae - femoral fractures - risk factors - Staphylococcus

* Work developed at the Microbiology, Immunology and Parasitology of the School of Medical Sciences of the Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil, and of the Hospital Geral de Fortaleza/Exército Brasileiro, Fortaleza, Ceará, Brazil




Publication History

Received: 10 December 2020

Accepted: 07 April 2021

Article published online:
05 January 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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