Treatment of the infections caused by methicillin-resistant Staphylococcus aureus (MRSA) strains in orthopedic patients is a difficult and laborious process for both the patient and physician. Staphylococcus aureus(S. aureus) is one of the leading causes of community-acquired and nosocomial infections. In this study, we aimed to investigate the susceptibilityof the MRSA strainsisolated in orthopedic patients cultured for different reasons in our clinic to various antibiotics, and to evaluate clinical characteristics of the patients and factors affecting the prognosis. A total of 40 patients with MRSAisolated in our orthopedics clinic between December 2012 and November 2016 were retrospectively analyzed. Data including age, sex, comorbidities, previous surgeries, and previous antibiotic treatments were obtained from patients’ files and electronic information system. Of 40 patients, 60% were male, and 56% were over 60 years old. While 80% of the patients underwent an orthopedic surgery, 20% of them received no surgical intervention before the diagnosis. A total of 90% were in-patients, and the mean length of hospital stay was 22 days. The mean time from the date of hospitalization to the isolation of MRSA was 12 days. According to the consultation findings, in the clinical recovery process of the patients and in the treatment algorithm given to those patients, vancomycin and teicoplanin were found to be among the most important treatment options, in addition to significant debridement to be done, for MRSA strains. Our study results suggestthat, in addition to the surgical debridement, timely antibiotherapy is of utmost importance to reduce mortality and morbidity in MRSA-positive orthopedic patients.
Jensen AG, Wachmann CH, Poulsen KB, Espersen F, Scheibel J, Skinhøj P, Frimodt-Møller N. Risk factors for hospital-acquired Staphylococcus aureus bacteremia. Arch Intern Med. 1999;159(3):1437-44.
Zafar AB, Butler RC, Reese DJ, Gaydos LA, Mennonna PA. Use of 0.3% triclosan (Bacti-Stat) to eradicate an outbreak of methicillin-resistant Staphylococcus aureus in a neonatal nursery. Am J Infect Control. 1995;23(3):200-8.
Cameron DR, Howden BP, Peleg AY. The interface between antibiotic resistance and virulence in Staphylococcus aureus and its impact upon clinical outcomes, Clin Infect Dis. 2011;53(6):576-82.
Centers for Disease Control and Prevention. Staphylococcus aureus resistant to vancomycinUnited States 2002, MMWR. 2002;51(26):565-7.
Ayliffe GAJ. The progressive intercontinental spread of methicillin-resistant Staphylococcus aureus. Clin Infect Dis. 1997;24(Suppl 1):574-9.
Hudson IRB. The efficacy of intranasal mupirocin in the prevention of Staphylococcal infections: A review of recent experience. J Hosp Infect. 1994; 27(2):81-98.
Crowcroft NS, Ronveaux O, Monnet DL, Mertens R. Methicillin-resistant Staphylococcus aureus and antimicrobial use in Belgian Hospitals. Infect Control Hosp Epidemiol. 1999;20:316.
Jernigan JA, Clemence MA, Stott GA, Titus MG, Alexander CH, Palumbo CM, Farr BM. Control of methicillin-resistant Staphylococcus aureus at a university hospital: One decade later. Infect Control Hospital Epidemiol. 1995;16(12):686-96.
Boyce JM, Potter-Bynoe G, Chenevert C, King T. Environmental contamination due to methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol. 1997;18:622-7
Holmes NE, Turnidge JD, Munckhof WJ, Robinson JO, Korman TM, O’Sullivan MV, Anderson TL, Roberts SA, Gao W, Christiansen KJ, Coombs GW, Johnson PD, Howden BP. Antibiotic choice may not explain poorer outcomes in patients with Staphylococcus aureus bacteremia and high vancomycin minimum inhibitory concentrations, J Infect Dis. 2011;204(3):340-7.
Kluytman J, Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: Epidemiology, underlying mechanisms and associated risks. Clin Microbiol Rev. 1997;10(3):505-20.
Bannerman TL, Hancock GA, Tenover FC, Miller JM. Pulsed-field gel electrophoresis as a replacement for bacteriophage typing of Staphylococcus aureus. J Clin Microbiol. 1995;33(3):551-5.
Lowy F. Staphylococcus aureus infections. N Engl J Med. 1998;339:520-32.
Doebbeling BN. Nasal and hand carriage of Staphylococcus aureus in healthcare workers. J Chemotherapy. 1994;6(Suppl 2):11-7.
Nicolle LE, Dyck B, Thompson G, Roman S, Kabani A, Plourde P, Fast M, Embil J. Regional dissemination and control of epidemic methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol. 1999;20(3):202-5.
Onorato M, Borucki MJ, Baillargeon G, Paar DP, Freeman DH, Cole CP, Mayhall CG. Risk factors for colonization or infection due to methicillinresistant Staphylococcus aureus in HIV-positive patients: A retrospective case control study. Infect Control Hosp Epidemiol. 1999;20(1):26-30.
Miller MA, Dascal A, Portnoy J, Mendelson J. Development of mupirocin resistance among of methicillin-resistant Staphylococcus aureus after widespread use of nasal mupirocin ointment. Infect Control Hosp Epidemiol. 1996;17(12):811-3.
Tenover FC, Arbeit K, Archer G, Biddle J, Byrne S, Goering R, Hancock G, Hébert GA, Hill B, Hollis R, Comparison of traditional and molecular methods of typing isolates of Staphylococcus aureus. J Clin Microbiol. 1994;32(2):407-15.