Incidence of staphylococcus aureus infections after surgical interventions: a systematic review and meta-analysis

Postoperative Staphylococcus aureus (S. aureus) infections are associated with increased morbidity and mortality. This systematic review and meta-analysis aimed to summarize the incidence of postoperative S. aureus infections. We searched MEDLINE, CENTRAL, and Embase (2008-2023) for studies reporting S. aureus infections after hip or knee replacement, spinal surgery, craniotomy, coronary artery bypass surgery (CABG), open colon surgery, abdominal hysterectomy, cesarean section, peripheral vascular bypass, or elective plastic surgery in selected developed countries were considered. We conducted meta-analysis with a generalized linear mixed model and assessed risk of bias. This study is registered with PROSPERO,CRD42023416876. Data from 224 studies indicated a cumulative incidence of deep S. aureus infection after hip surgery 5.05 infections/1000 procedures (95%CI 3.29-7.74), 5.59 (95%CI 3.62-8.63) after knee surgery, 11.74 (95% CI 9.08-15.16) after spinal surgery, and 7.23 (95%CI 1.63-31.86) after CABG surgery. S. aureus infections were associated with increased all-cause mortality among CABG, hip, knee and spinal surgeries. Patients cohorts who received antibiotic prophylaxis and/or underwent decolonization demonstrated lower incidence of S. aureus infections. The incidence of S. aureus infections varies by procedure, with highest rates seen after spinal surgeries and hysterectomies. Findings highlight the importance of standardized prevention across surgical settings.