The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty

Tristan Symonds; Hannah Brien; Benjamin Parkinson; Andrea Grant; Kenji Doma

doi:doi:10.11648/j.js.20200803.11

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The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty

Tristan Symonds, Hannah Brien, Benjamin Parkinson, Andrea Grant, Kenji Doma

Published in Journal of Surgery (Volume 8, Issue 3)

Received: 7 April 2020 Accepted: 26 April 2020 Published: 19 May 2020

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Abstract

Prosthetic joint infections are responsible for a high morbidity and economic cost in patients undergoing total joint arthroplasty. Staphylococcus aureus (S Aureus) is a key modifiable risk factor in the reduction of surgical site infections (SSI). Evidence suggests that decolonization of S aureus carriers reduces the risk of SSI. Octenidine is an antiseptic active against gram-positive and gram-negative bacteria. The aim of this study is to establish the eradication rate of S aureus in patients undergoing total joint arthroplasty using an Octenidine decolonisation protocol prior to surgery. This was a prospective case series performed at the Cairns Private Hospital during a five month trial period of using Octenidine wash and nasal gel in patients undergoing elective TJA. Patients undergoing total joint arthroplasty during a five-month trial period had pre-operative nasal swabs to screen for S aureus pre and post Octenidine treatment. All patients underwent a body wash and nasal gel protocol for five days using Octenidine. The primary outcome was to determine decolonisation rates in patients following the protocol. A total of 183 patients met inclusion criteria into this study. At the first swab 151 (82.5%) patients had normal regional flora and 32 (17.5%) were positive for S aureus. Of these 32 patients 30 (93.75%) were negative for MRSA and 2 (6.25%) had non-multiresistant MRSA. The decolonization rate for patients with S aureus was 76.6%. It was unsuccessful in clearing the two patients with nmMRSA. Octenidine is effective in reducing S aureus colonisation in patients undergoing total joint arthroplasty. Further studies are required to compare this agent to traditional mupirocin based protocols to determine its efficacy as an alternative for use in pre-operative staphylococcal decolonisation.

Published in	Journal of Surgery (Volume 8, Issue 3)
DOI	10.11648/j.js.20200803.11
Page(s)	81-85
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Total Joint Arthroplasty, Decolonization, Octenidine, Staphylococcus Aureus, Prosthetic Joint Infections

References

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APA Style

Tristan Symonds, Hannah Brien, Benjamin Parkinson, Andrea Grant, Kenji Doma. (2020). The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty. Journal of Surgery, 8(3), 81-85. https://doi.org/10.11648/j.js.20200803.11

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ACS Style

Tristan Symonds; Hannah Brien; Benjamin Parkinson; Andrea Grant; Kenji Doma. The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty. J. Surg. 2020, 8(3), 81-85. doi: 10.11648/j.js.20200803.11

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AMA Style

Tristan Symonds, Hannah Brien, Benjamin Parkinson, Andrea Grant, Kenji Doma. The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty. J Surg. 2020;8(3):81-85. doi: 10.11648/j.js.20200803.11

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@article{10.11648/j.js.20200803.11,
  author = {Tristan Symonds and Hannah Brien and Benjamin Parkinson and Andrea Grant and Kenji Doma},
  title = {The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty},
  journal = {Journal of Surgery},
  volume = {8},
  number = {3},
  pages = {81-85},
  doi = {10.11648/j.js.20200803.11},
  url = {https://doi.org/10.11648/j.js.20200803.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200803.11},
  abstract = {Prosthetic joint infections are responsible for a high morbidity and economic cost in patients undergoing total joint arthroplasty. Staphylococcus aureus (S Aureus) is a key modifiable risk factor in the reduction of surgical site infections (SSI). Evidence suggests that decolonization of S aureus carriers reduces the risk of SSI. Octenidine is an antiseptic active against gram-positive and gram-negative bacteria. The aim of this study is to establish the eradication rate of S aureus in patients undergoing total joint arthroplasty using an Octenidine decolonisation protocol prior to surgery. This was a prospective case series performed at the Cairns Private Hospital during a five month trial period of using Octenidine wash and nasal gel in patients undergoing elective TJA. Patients undergoing total joint arthroplasty during a five-month trial period had pre-operative nasal swabs to screen for S aureus pre and post Octenidine treatment. All patients underwent a body wash and nasal gel protocol for five days using Octenidine. The primary outcome was to determine decolonisation rates in patients following the protocol. A total of 183 patients met inclusion criteria into this study. At the first swab 151 (82.5%) patients had normal regional flora and 32 (17.5%) were positive for S aureus. Of these 32 patients 30 (93.75%) were negative for MRSA and 2 (6.25%) had non-multiresistant MRSA. The decolonization rate for patients with S aureus was 76.6%. It was unsuccessful in clearing the two patients with nmMRSA. Octenidine is effective in reducing S aureus colonisation in patients undergoing total joint arthroplasty. Further studies are required to compare this agent to traditional mupirocin based protocols to determine its efficacy as an alternative for use in pre-operative staphylococcal decolonisation.},
 year = {2020}
}

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TY - JOUR
T1 - The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty
AU - Tristan Symonds
AU - Hannah Brien
AU - Benjamin Parkinson
AU - Andrea Grant
AU - Kenji Doma
Y1 - 2020/05/19
PY - 2020
N1 - https://doi.org/10.11648/j.js.20200803.11
DO - 10.11648/j.js.20200803.11
T2 - Journal of Surgery
JF - Journal of Surgery
JO - Journal of Surgery
SP - 81
EP - 85
PB - Science Publishing Group
SN - 2330-0930
UR - https://doi.org/10.11648/j.js.20200803.11
AB - Prosthetic joint infections are responsible for a high morbidity and economic cost in patients undergoing total joint arthroplasty. Staphylococcus aureus (S Aureus) is a key modifiable risk factor in the reduction of surgical site infections (SSI). Evidence suggests that decolonization of S aureus carriers reduces the risk of SSI. Octenidine is an antiseptic active against gram-positive and gram-negative bacteria. The aim of this study is to establish the eradication rate of S aureus in patients undergoing total joint arthroplasty using an Octenidine decolonisation protocol prior to surgery. This was a prospective case series performed at the Cairns Private Hospital during a five month trial period of using Octenidine wash and nasal gel in patients undergoing elective TJA. Patients undergoing total joint arthroplasty during a five-month trial period had pre-operative nasal swabs to screen for S aureus pre and post Octenidine treatment. All patients underwent a body wash and nasal gel protocol for five days using Octenidine. The primary outcome was to determine decolonisation rates in patients following the protocol. A total of 183 patients met inclusion criteria into this study. At the first swab 151 (82.5%) patients had normal regional flora and 32 (17.5%) were positive for S aureus. Of these 32 patients 30 (93.75%) were negative for MRSA and 2 (6.25%) had non-multiresistant MRSA. The decolonization rate for patients with S aureus was 76.6%. It was unsuccessful in clearing the two patients with nmMRSA. Octenidine is effective in reducing S aureus colonisation in patients undergoing total joint arthroplasty. Further studies are required to compare this agent to traditional mupirocin based protocols to determine its efficacy as an alternative for use in pre-operative staphylococcal decolonisation.
VL - 8
IS - 3
ER -

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Author Information

Tristan Symonds

Orthopaedic Research Institute of Queensland, Townsville, Queensland
Hannah Brien

Cairns Private Hospital, Cairns, Queensland
Benjamin Parkinson

Orthopaedic Research Institute of Queensland, Townsville, Queensland
Andrea Grant

Orthopaedic Research Institute of Queensland, Townsville, Queensland
Kenji Doma

Orthopaedic Research Institute of Queensland, Townsville, Queensland

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APA Style

Tristan Symonds, Hannah Brien, Benjamin Parkinson, Andrea Grant, Kenji Doma. (2020). The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty. Journal of Surgery, 8(3), 81-85. https://doi.org/10.11648/j.js.20200803.11

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ACS Style

Tristan Symonds; Hannah Brien; Benjamin Parkinson; Andrea Grant; Kenji Doma. The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty. J. Surg. 2020, 8(3), 81-85. doi: 10.11648/j.js.20200803.11

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AMA Style

Tristan Symonds, Hannah Brien, Benjamin Parkinson, Andrea Grant, Kenji Doma. The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty. J Surg. 2020;8(3):81-85. doi: 10.11648/j.js.20200803.11

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@article{10.11648/j.js.20200803.11,
  author = {Tristan Symonds and Hannah Brien and Benjamin Parkinson and Andrea Grant and Kenji Doma},
  title = {The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty},
  journal = {Journal of Surgery},
  volume = {8},
  number = {3},
  pages = {81-85},
  doi = {10.11648/j.js.20200803.11},
  url = {https://doi.org/10.11648/j.js.20200803.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200803.11},
  abstract = {Prosthetic joint infections are responsible for a high morbidity and economic cost in patients undergoing total joint arthroplasty. Staphylococcus aureus (S Aureus) is a key modifiable risk factor in the reduction of surgical site infections (SSI). Evidence suggests that decolonization of S aureus carriers reduces the risk of SSI. Octenidine is an antiseptic active against gram-positive and gram-negative bacteria. The aim of this study is to establish the eradication rate of S aureus in patients undergoing total joint arthroplasty using an Octenidine decolonisation protocol prior to surgery. This was a prospective case series performed at the Cairns Private Hospital during a five month trial period of using Octenidine wash and nasal gel in patients undergoing elective TJA. Patients undergoing total joint arthroplasty during a five-month trial period had pre-operative nasal swabs to screen for S aureus pre and post Octenidine treatment. All patients underwent a body wash and nasal gel protocol for five days using Octenidine. The primary outcome was to determine decolonisation rates in patients following the protocol. A total of 183 patients met inclusion criteria into this study. At the first swab 151 (82.5%) patients had normal regional flora and 32 (17.5%) were positive for S aureus. Of these 32 patients 30 (93.75%) were negative for MRSA and 2 (6.25%) had non-multiresistant MRSA. The decolonization rate for patients with S aureus was 76.6%. It was unsuccessful in clearing the two patients with nmMRSA. Octenidine is effective in reducing S aureus colonisation in patients undergoing total joint arthroplasty. Further studies are required to compare this agent to traditional mupirocin based protocols to determine its efficacy as an alternative for use in pre-operative staphylococcal decolonisation.},
 year = {2020}
}

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