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• W2087579300 abstract "Objective. To assess the impact of antibiotic prophylaxis on the emergence of vancomycin-resistant strains of Enterococcus faecium, Enterococcus faecalis , and Staphylococcus aureus and the incidence of surgical site infection (SSI) after vancomycin or cefazolin prophylaxis for femoral neck fracture surgery. Design. Prospective cohort study. Setting. A hospital with a high prevalence of methicillin-resistant S. aureus (MRSA) carriage. Patients. All patients admitted with a femoral neck fracture from March 1, 2004 through February 28, 2005 were prospectively identified and screened for MRSA and vancomycin-resistant (VRE) carriage at admission and at day 7. Deep incisional and organ/space SSIs were also recorded. Results. Of 263 patients included in the study, 152 (58%) received cefazolin and 106 (40%) received vancomycin. At admission, the prevalence of MRSA carriage was 6.8%; it was 12% among patients with risk factors and 2.2% among patients with no risk factors ( P = .002). At day 7 after surgery, there were 6 patients (2%) who had hospital-acquired MRSA, corresponding to 0.7% in the cefazolin group and 5% in the vancomycin group ( P = .04); none of the MRSA isolates were resistant to glycopeptides. The rate of VRE carriage at admission was 0.4%. Three patients (1%) had acquired carriage of VRE (1 had E. faecium and 2 had E. faecalis ); all 3 were in the cefazolin group (2% of patients) and none in the vancomycin group ( P = .27). Eight SSIs (3%) occurred, 4% in the cefazolin group and 2% in the vancomycin group ( P = .47). Conclusions. This preliminary study demonstrates that cefazolin and vancomycin prophylaxis have similar impacts on the emergence of glycopeptide-resistant pathogens. Neither MRSA infection nor increased rates of SSI with other bacteria were observed in the vancomycin group, suggesting that a larger multicenter study should be initiated." @default.
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• W2087579300 date "2006-12-01" @default.
• W2087579300 modified "2023-10-18" @default.
• W2087579300 title "Comparison of Routine Prophylaxis With Vancomycin or Cefazolin for Femoral Neck Fracture Surgery: Microbiological and Clinical Outcomes" @default.
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• W2087579300 doi "https://doi.org/10.1086/509846" @default.
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