Project Snapshot

Prevention of Transmission Pillar

Implementation of Decolonization for Staphylococcus aureus prior to hip and knee replactments in Alberta

Project Key Words: Decolonization, Quality Improvement, Health Economics

Principal Investigator: Elissa Rennert-May, MD, MSc; Jenine Leal, PhD

Co-Investigator(s): John Conly, MD; Stephanie Smith, MD, MSc; Shannon Puloski, MD; Braden Manns, MD, MSc

Project Theme: Policy, Economics, & Sustainability

The Aim

The purpose of this project is to study the implementation of a new decolonization protocol prior to hip and knee replacement in Alberta, as well as study relevant patient outcomes.

Why is This Important?

There are an increasing number of hip and knee replacements annually in Alberta and with this we have seen a rise in the number of deep surgical site infections which are costly and result in poor quality of life. However, it is difficult to standardize changes to care across varying healthcare zones.


Successful implementation of a decolonization protocol for Staphylococcus aureus prior to hip and knee replacement.

Research Questions

  1. Is it possible to implement an effective decolonization protocol prior to knee and hip replacements?
  2. What is the quality of life of patients who develop surgical site infections and what are the associated costs?
  3. Are the rates of resistance to topical antimicrobials affected by decolonization bundles?


Our Approach

  1. With the co-operation of the Alberta hip and knee clinics and the Alberta Bone and Joint Health Institute we will assess patient compliance with decolonization through secondary information sources.
  2. Infection prevention and control surveillance will be used to capture infection rates.
  3. EQ-5D questionnaires will be used to capture a patient’s quality of life.
  4. Administrative costing data will be utilized to capture costs of patients who do and do not develop a complex surgical site infection.
  5. The research microbiology laboratory will test isolates from patients who develop a complex surgical site infection to determine if resistance to topical antimicrobials has developed.

Leveraged Sources of Support

  • Infection Prevention and Control
  • UofC Department of Medicine- Infrastructure will be used to leverage the MIF funds to apply for additional grants

Knowledge & Technology: Exchange and Exploitation


  • This work will serve to inform best-practice pre-operative policy
  • This study will help understand barriers to implementing changes in care pathways across different health care zones


Highly Qualified Personnel


  • 2 new investigator research scientists
  • Researchers from UofA and UofC
  • 1 Summer Student
  • 1 Research Associate
  • 1 Research Analyst