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
