{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T01:24:36Z","timestamp":1785201876555,"version":"3.55.0"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T00:00:00Z","timestamp":1739491200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X24002332_as1\"><jats:title>Objectives:<\/jats:title><jats:p>To identify risk factors for methicillin-susceptible (MSSA) and methicillin-resistant <jats:italic>S. aureus<\/jats:italic> (MRSA) nasal carriage and surgical site infection (SSI) among patients undergoing fracture fixation procedures who were included in a quality improvement protocol involving screening patients for <jats:italic>S. aureus<\/jats:italic> nasal carriage and treating carriers with intranasal mupirocin and chlorhexidine bathing.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002332_as2\"><jats:title>Design:<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002332_as3\"><jats:title>Setting:<\/jats:title><jats:p>Level 1 trauma center.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002332_as4\"><jats:title>Participants:<\/jats:title><jats:p>1,254 adults who underwent operative fixation of 1,298 extremity or pelvis fractures between 8\/1\/2014 \u2013 7\/31\/2017.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002332_as5\"><jats:title>Methods:<\/jats:title><jats:p>We calculated rates of <jats:italic>S. aureus<\/jats:italic> nasal carriage and SSI. We used multivariable stepwise logistic regression and selected the final models based on Akaike information criterion.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002332_as6\"><jats:title>Results:<\/jats:title><jats:p>Of the 1,040 screened first procedures, 262 (25.19%) were performed on <jats:italic>S. aureus<\/jats:italic> nasal carriers: 211 (20.29%) on MSSA carriers and 51 (4.90%) on MRSA carriers. Long-term care facility residence (odds ratio [OR] 3.38; 95% confidence interval [CI] 1.17\u20139.76) was associated with MRSA nasal carriage. After adjusting for statistically and clinically significant variables, MRSA carriage was significantly associated with any SSI (OR 4.58; 95% CI 1.63\u201312.88), <jats:italic>S. aureus<\/jats:italic> SSI (OR 10.11; 95% CI 3.25\u201331.42), and MRSA SSI (OR 27.25; 95% CI 5.33\u2013139.24), whereas MSSA carriage was not. Among <jats:italic>S. aureus<\/jats:italic> carriers, any chlorhexidine use was documented for 232 (88.55%), and any intranasal mupirocin was documented for 85 (40.28%) MSSA carriers and 33 (64.71%) MRSA carriers.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002332_as7\"><jats:title>Conclusions:<\/jats:title><jats:p>MRSA carriage was associated with a significant risk of SSI after operative fracture fixation. Many carriers did not undergo decolonization, suggesting that a simplified decolonization protocol is needed.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2024.233","type":"journal-article","created":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T07:07:57Z","timestamp":1739516877000},"page":"384-390","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["<i>Staphylococcus aureus<\/i> colonization and surgical site infections among patients undergoing surgical fixation for acute fractures"],"prefix":"10.1017","volume":"46","author":[{"given":"Megan","family":"Ahmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3306-7706","authenticated-orcid":false,"given":"Jocelyn","family":"Compton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Pottinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3102-8992","authenticated-orcid":false,"given":"Richard","family":"Uhlenhopp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1054-6475","authenticated-orcid":false,"given":"Melissa","family":"Ward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9026-7128","authenticated-orcid":false,"given":"Ambar","family":"Haleem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6922-8471","authenticated-orcid":false,"given":"Michael","family":"Willey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3604-0093","authenticated-orcid":false,"given":"Marin","family":"Schweizer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9530-6859","authenticated-orcid":false,"given":"Loreen","family":"Herwaldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,2,14]]},"reference":[{"key":"S0899823X24002332_ref28","doi-asserted-by":"publisher","DOI":"10.3201\/eid1605.090851"},{"key":"S0899823X24002332_ref32","doi-asserted-by":"publisher","DOI":"10.1086\/676866"},{"key":"S0899823X24002332_ref2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000158"},{"key":"S0899823X24002332_ref24","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.00919"},{"key":"S0899823X24002332_ref25","doi-asserted-by":"publisher","DOI":"10.1086\/533494"},{"key":"S0899823X24002332_ref17","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197658040-00004"},{"key":"S0899823X24002332_ref21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0038127"},{"key":"S0899823X24002332_ref5","doi-asserted-by":"publisher","DOI":"10.1086\/501763"},{"key":"S0899823X24002332_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.04.039"},{"key":"S0899823X24002332_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.03.036"},{"key":"S0899823X24002332_ref26","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268818001644"},{"key":"S0899823X24002332_ref35","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20140528-59"},{"key":"S0899823X24002332_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.06.062"},{"key":"S0899823X24002332_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2007.07.034"},{"key":"S0899823X24002332_ref27","doi-asserted-by":"publisher","DOI":"10.3109\/17453670903110675"},{"key":"S0899823X24002332_ref13","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.91B2.21715"},{"key":"S0899823X24002332_ref1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e318284704e"},{"key":"S0899823X24002332_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2015.08.003"},{"key":"S0899823X24002332_ref30","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.00549"},{"key":"S0899823X24002332_ref15","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp120568"},{"key":"S0899823X24002332_ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4205-y"},{"key":"S0899823X24002332_ref10","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.3480"},{"key":"S0899823X24002332_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2014.05.019"},{"key":"S0899823X24002332_ref19","unstructured":"19. 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