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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2022; 63(03): e158-e163
DOI: 10.1055/s-0042-1749131
Artículo Original | Original Article

Prevalencia de portación nasal de Staphylococcus aureus sensible y resistente a la meticilina en candidatos a artroplastia total de cadera o rodilla

Article in several languages: español | English
David Dabed 
1   Servicio de Traumatología, Clínica Red Salud, Santiago, Chile
2   Servicio de Traumatología, Hospital El Carmen Dr. Luis Valentín Ferrada, Santiago, Chile
,
Joaquín Valenzuela 
3   Servicio de Traumatología, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile
4   Servicio de Traumatología, Clínica Universidad de Los Andes, Santiago, Chile
,
Martín Salgado
3   Servicio de Traumatología, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile
5   Servicio de Traumatología, Pontificia Universidad Católica de Chile, Santiago, Chile
,
Maximiliano Carmona 
3   Servicio de Traumatología, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile
5   Servicio de Traumatología, Pontificia Universidad Católica de Chile, Santiago, Chile
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Resumen

Introducción Las infecciones perioperatorias en cirugía de reemplazo articular son fuente importante de morbimortalidad, así como de altos costos económicos y sociales, tanto para el paciente como para su entorno. La colonización preoperatoria por Staphylococcus aureus ha sido reconocida como un factor de riesgo importante para desarrollar una infección de sitio quirúrgico.

El objetivo de este estudio es conocer la prevalencia de portación nasal de S. aureus, tanto sensible a la meticilina (SASM) como resistente a la meticilina (SARM), en pacientes candidatos a cirugía de reemplazo articular de cadera o rodilla.

Materiales y métodos Se realizó un estudio observacional de una cohorte retrospectiva de pacientes con indicación de artroplastia total de cadera (ATC) y rodilla (ATR) electiva por artrosis severa en un hospital público de Chile. Los pacientes fueron sometidos a tamizaje preoperatorio de portación, cultivándose muestras obtenidas mediante hisopado de ambas fosas nasales. Los datos del laboratorio fueron recopilados y presentados como porcentaje de portación de S. aureus.

Resultados Se estudiaron 303 pacientes consecutivos de ATC y 343 de ATR. En total, 483 de los 646 pacientes (74,7%) tuvieron estudio preoperatorio de portación nasal. Se identificaron 123 pacientes (25,4%) portadores de S. aureus, de los cuales sólo 2 (0,41%) casos correspondieron a SARM.

Conclusión La prevalencia de portación nasal de S. aureus obtenida fue de 25%, similar a lo reportado en otras series. La prevalencia de SARM (0.41%), sin embargo, estuvo bajo lo descrito en la literatura internacional (0,6–6%). Sería de utilidad, dada la alta prevalencia de portación descrita en nuestro trabajo y de acuerdo a evidencia publicada recientemente, realizar protocolos de descolonización universales, sin necesidad de realizar tamizaje preoperatorio.

Palabras Clave

prótesis total de cadera - prótesis total de rodilla - tamizaje preoperatorio - Staphylococcus aureus - decolonización

Financiación

Los autores declaran que el presente estudio no contó con apoyo financiero externo de ningún tipo.




Publication History

Received: 14 September 2021

Accepted: 30 March 2022

Article published online:
28 December 2022

© 2022. Sociedad Chilena de Ortopedia y 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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