Staphylococcus aureus Colonization in Patients Undergoing Total Hip or Knee Arthroplasty and Costeffectiveness of Decolonization Programme

Background: Periprosthetic joint infection is a devastating complication of total joint arthroplasty. It seems that thepatient’s skin, nose, throat, and urine are important sites for microbial colonization. Colonization with staphylococcusaureus, especially methicillin resistant increases the risk of periprosthetic joint infection. The aim of this study was toassess the prevalence of staphylococcus aureus colonization in patients candidate for arthroplasty in central Iran aswell as cost-effectiveness of decolonization program for prevention of post-arthroplasty infection.Methods: A total of 226 patient candidates for total joint arthroplasty were enrolled in this prospective cross-sectionalstudy between January 2014 and January 2016. Specimens from nose, throat, groin skin, and urine were sent forbacteriologic culture and sensitivity test. Analysis cost-effectiveness was then performed for decolonization programme.Results: Patients had positive cultures from nose (15.9%), throat (4.4%), groin skin (3.1%), and urine (0.9%). Ingeneral, 20.8% of the patients had positive cultures for staphylococcus aureus, among whom, 1.8% were methicillinresistant. Based on cost-effectiveness analysis, decolonization program leads to 80% reduction in costs.Conclusion: According to our results, although colonization with methicillin sensitive staphylococcus aureus in patientsundergoing hip or knee arthroplasty is lower than other studies but colonization with methicillin resistant staphylococcusaureus is similar to others. Also, decolonization programme in these patients was found to be very cost-effective.Level of evidence: II