Elimination of Staphylococcus aureus Nasal Carriage in Health Care Workers: Analysis of Six Clinical Trials with Calcium Mupirocin Ointment

Doebbeling, Bradley N.; Breneman, Debra; Neu, Harold C.; Aly, Raza; Yangco, Bienvenido G.; Holley, H. Preston; Marsh, R.; Pfaller, Michael A.; McGowan, John E.; Scully, Brian E.; Reagan, David R.; Wenzel, Richard P.

doi:10.1093/clinids/17.3.466

Cited by 170 publications

(84 citation statements)

References 29 publications

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“…A topic bacterial agent has been used to eradicate nasal cavities, armpits, groins and in the hands of patients and health workers. Through this measure, we could reduce the infection rates among patients that will undergo surgeries (26) .…”

Section: Discussionmentioning

confidence: 99%

Perfil fenotípico e genotípico de Staphylococcus aureus isolados de estudantes de enfermagem, 2008

Faria¹,

Piekarski²,

Tognim

et al. 2011

Acta paul. enferm.

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Objective: To investigate the prevalence of nasal entrainment, phenotypic and genotypic profile of Staphylococcus aureus, as isolated from nursing students. Methods: A cross-sectional population of 101 students enrolled in the first three grades of the undergraduate nursing course in 2008. Staphylococcus aureus was isolated from biological material obtained from the swab through the nasal vestibules. Susceptibility to oxacillin and vancomycin was determined by minimum inhibitory concentration test. The mecA gene was identified by testing the polymerase chain reaction. Results: There was a 90.1% positive finding of Staphylococcus aureus. The frequency of oxacillin resistance was 9.8%; all samples were sensitive to vancomycin. The eight strains resistant to oxacillin carried the mecA gene. Conclusion: The prevalence of Staphylococcus aureus was high. Oxacillin resistance was significant, but all strains were sensitive to vancomycin. RESUMENObjetivo: Verificar la prevalencia de transporte nasal, perfil fenotípico y genotípico de S. aureus aislados de estudiantes de enfermería. Métodos: Estudio transversal, con población compuesta por 101 alumnos, cursando las tres primeras series del Pregrado en Enfermería en el año 2008. El S. aureus fue aislado del material biológico obtenido de los vestíbulos nasales a través de swab. La susceptibilidad a la oxacilina y vancomicina fue determinada por el test de concentración inhibitoria mínima. La presencia del gen MecA fue determinada por el test de reacción en cadena de la polimerasa. Resultados: Se verificó el 90,1% de positividad para el S. aureus. La frecuencia de resistencia a la oxacilina fue de 9,8% y todas las muestras fueron sensibles a la vancomicina. Las ocho muestras resistentes a la oxacilina presentaron el gen MecA. Conclusión: La prevalencia fue elevada. La resistencia a la oxacilina fue expresiva y todas las muestras fueron sensibles a la vancomicina. Las muestras resistentes a la oxacilina transportaban el gen MecA.

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Section: Discussionmentioning

confidence: 99%

Perfil fenotípico e genotípico de Staphylococcus aureus isolados de estudantes de enfermagem, 2008

Faria¹,

Piekarski²,

Tognim

et al. 2011

Acta paul. enferm.

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“…It was found that the risk of infection in deep tissues of the surgical site in Mupirocin-treated patients was five times less than the control group (11). In a large scale study, 91% successful eradication of S. aureus carriers with Mupirocin has been reported (12). Different results have been reported on the effectiveness of eradicating carriers in prevention of surgical, orthopedic and cardiac surgery wound infections, while Gernaat and Kluytmans studies clearly demonstrated that treatment with Mupirocin could significantly decrease postoperative infections (13,14).…”

Section: Methodsmentioning

confidence: 98%

Effect of Mupirocin Treatment in Eradication of Staphylococcus aureus Nasal Carriage among Intensive Care Unit Personnel

Kaboosi

Del²,

Ghaemi

et al. 2016

mljgoums

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Background and Objective: Staphylococcus aureus is the most common and important infectious agent. This bacterium can enter the bloodstream and cause some complications in the intensive care unit (ICU).This organism can frequently be found in the nose and transmitted by the carriers. This study aimed to determine the efficiency of eradicating S. aureus from the nose of ICU personnel in reducing the risk of S. aureus infections in the Panje Azar Hospital in Gorgan, Iran.Methods: Sampling was done using sterile swabs collected from the anterior nasal passages.All samples containing Gram-positive cocci were sent to the laboratory of Faculty of Medicine for identification and evaluation of methicillin resistance. All S. aureus nasal carriers were treated with mupirocin ointment b.d for 5 days. The Samples were cultured again after five weeks to evaluate the eradication of S. auerus from the nose of subjects.Results: Overall, seven ICU personnel (11.7%) were S. aureus carriers. Two isolates (3.3%) were found as methicillin resistant using both methods of disc diffusion and PCR. The frequency distribution of positive cases indicated a significant difference in terms of work experience (P = 0.012). Conclusion:The findings show that treatment of carriers with 2% mupirocin topical ointment eradicates S. aureus from the nose. No S. aureus isolates was found in reculture of nasal samples. Treatment of healthy carriers can significantly reduce the risk of infections caused by the bacterium in the ICU.

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“…Selective suppression and/or eradication of MRSA carriage using mupirocin has been used adjunctively to help control spread of MRSA, 32 " 38 but successful eradication is sometimes transient. Doebbeling et al 39 reported that 26% of patients were recolonized within 4 weeks after decolonization, and 48% of patients who underwent an eradication protocol were culture positive for MRSA after 6 months. 40 Use of mupirocin to eradicate MRSA colonization was studied in a randomized, controlled trial involving colonized hospital patients in Switzerland.…”

Section: Several Studies In This Issue Of Infection Control and Hospitalmentioning

confidence: 99%

“…Hospital-wide rates of MRSA HAI were not reported; perhaps eradication with mupirocin merely delayed the onset of MRSA infection, and so it would not be reflected in the reported rate of MRSA HAIs in the ICU. Because recolonization has been reported, 39 ' 40 it would have been useful to follow up the decolonized cohort longitudinally and assess MRSA colonization and infection status.…”

Section: Several Studies In This Issue Of Infection Control and Hospitalmentioning

confidence: 99%

Methicillin-ResistantStaphylococcus aureusControl: We Didn't Start the Fire, but It's Time to Put It Out

Muto

2006

Infect. Control Hosp. Epidemiol.

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The prevalence of healthcare-associated infections (HAIs) caused by multidrug-resistant organisms has significantly increased over the past decade, according to the measurements of the Centers for Disease Control and Prevention, and will likely continue to climb. 1 ' 2 Currently, more than 70% of HAIs are caused by bacteria that are resistant to at least 1 of the drugs most commonly used to treat these infections. 3 These HAIs have been associated with increased cost and mortality, compared with infections due to antibiotic-susceptible strains of the same bacterial species. 4,5 Nevertheless, despite decades of studies confirming increased rates of adverse events related to these organisms and ongoing evidence of increased prevalence of multidrug-resistant organisms, 2 as well as the emergence of new antimicrobial-resistant organisms, 6 few coordinated effective efforts exist across the United States and most parts of the world to prevent MRSA transmission and reduce the number of MRSA HAIs. 7 Despite evidence of efficacy for control of multidrug-resistant organisms with active surveillance cultures and barrier precautions 8 " 10 and despite documented failure to control MRSA in studies lacking methods to fully identify the MRSA reservoir, 8 most healthcare systems have not elected to implement methods to identify and contain MRSA, and so MRSA continues to spread and to colonize and infect patients. Several studies in this issue of Infection Control and HospitalEpidemiology describe efforts to control methicillin-resistant S. aureus (MRSA). I comment here on 3 of them. 11 " 13 Interestingly, the investigators in these 3 studies believe that colonized patients represented a significant portion of the MRSA reservoir and elected to implement a program of active surveillance cultures to better identify MRSA-colonized patients. In two of the studies, that of Salgado and Farr 11 and that of Eveillard et al., 12 barrier precautions were implemented for all patients identified as being MRSA colonized, as recommended by the recent Society for Healthcare Epidemiology of America (SHEA) guideline. 8 The third study, by Sandri et al., 13 discusses the utility of MRSA decolonization of the nares by administration of topical mupirocin therapy and chlorhexidine baths to all patients identified as having MRSA colonization of the nares.The study by Salgado and Farr" reports the proportion of patients identified by active surveillance culture on admission as being MRSA colonized who later had an MRSA-positive clinical microbiology culture, the number and type of clinical microbiology cultures done, and the number and type of MRSA-positive clinical microbiology cultures. Their study demonstrates that only 15% of all patients identified as being colonized with MRSA on admission would have been so identified subsequently via clinical microbiology culture. When data for patients in the intensive care unit (ICU) and in other units (non-ICU patients) were analyzed separately, the investigators found that 21.4% of ICU patients had a subse...

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Elimination of Staphylococcus aureus Nasal Carriage in Health Care Workers: Analysis of Six Clinical Trials with Calcium Mupirocin Ointment

Cited by 170 publications

References 29 publications

Perfil fenotípico e genotípico de Staphylococcus aureus isolados de estudantes de enfermagem, 2008

Perfil fenotípico e genotípico de Staphylococcus aureus isolados de estudantes de enfermagem, 2008

Effect of Mupirocin Treatment in Eradication of Staphylococcus aureus Nasal Carriage among Intensive Care Unit Personnel

Methicillin-ResistantStaphylococcus aureusControl: We Didn't Start the Fire, but It's Time to Put It Out

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