The Current State of Infection in Orthopaedic Surgery
The Centers for Disease Control and Prevention (CDC) estimates that 22% of all health-care-associated infections are surgical site infections. A CDC estimate from 2001 suggests that approximately 290,000 surgical site infections occur annually in the United States, resulting in $1 billion to $10 billion in direct and indirect medical costs. Approximately 8000 patient deaths are associated with these infections. Staphylococcus species including Staphylococcus aureus are the leading nosocomial pathogens in hospitals throughout the world and altogether total almost 30% of the pathogenic isolates of health-care-associated infection reported to the National Healthcare Safety Network from January 2006 to October 20071.
Multiple-drug-resistant organisms include methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, which colonize the skin and are spread by contact. Over 30% of the population is colonized with Staphylococcus aureus, and an increasing proportion of these resident bacteria is methicillin-resistant Staphylococcus aureus. As many as 4% of health-care workers may be colonized with methicillin-resistant Staphylococcus aureus, with up to 5% of these persons having a clinical infection2. These contribute to two types of infection, surgical and so-called nonsurgical (methicillin-resistant Staphylococcus aureus) infection. Additionally, there are two types of methicillin-resistant Staphylococcus aureus. Community-acquired methicillin-resistant Staphylococcus aureus and hospital-associated methicillin-resistant Staphylococcus aureus together have resulted in an increase in the incidence of nonsurgical infection of all types. Because of the increasing incidence, severity, and extent of disease caused by multiple-drug-resistant organisms, the prevention and treatment of these infections have become a national priority.
The Healthcare Infection Control Practices Advisory Committee (HICPAC) is a federal advisory committee made up of fourteen external infection control experts who provide advice and guidance to the CDC and the Secretary of the Department of Health and Human Services regarding the practice of health-care infection control and strategies for surveillance, prevention, and control of health-care-associated …
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