Use of Decolonization to Prevent Staphylococcal Infections in Various Healthcare Settings: Results of an Emerging Infections Network Survey

West, Sarah; Plantenga, BS Melissa S.; Strausbaugh, Larry J.

doi:10.1086/519930

Cited by 13 publications

(11 citation statements)

References 11 publications

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“…No mupirocin resistance was detected in the 199 MRSA isolates tested [30]. A more common use of nasal mupirocin in community settings is eradication of colonization to prevent recurrent infection in individual patients with furunculosis [49]. In one study, 34 patients with recurrent staphylococcal infection were treated with a 5-day course of mupirocin, and 17 were randomly selected to receive monthly 5-day mupirocin courses.…”

Section: Treatment and Prevention Of Community-associated Infectionmentioning

confidence: 99%

“…First, the incidence of community-associated skin and soft-tissue infection has apparently increased in the United States in recent years, likely driven by the emergence of community-associated MRSA strains [58]. In an effort to prevent the recurrence of skin and soft-tissue infection often associated with these strains, clinicians may increase use of mupirocin to eradicate MRSA colonization in patients and their families [49,[59][60][61][62].…”

Section: Will Mupirocin Resistance Become More Prevalent In the Unitementioning

confidence: 99%

“…Although routine use of decolonization therapy for MRSA carriers is not currently recommended by the guidelines of the Healthcare Infection Control Practices Advisory Committee [65], some US hospitals currently employ this strategy [49]. A recent multicenter study involving 3 US hospitals that showed a reduction in the rate of MRSA infection that was associated with this practice could further influence the use of mupirocin for preventing MRSA among general hospital populations, despite caution from the authors that their findings should be confirmed by additional studies [66].…”

Section: Will Mupirocin Resistance Become More Prevalent In the Unitementioning

confidence: 99%

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Mupirocin Resistance

2009

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With increasing pressure to prevent methicillin-resistant Staphylococcus aureus (MRSA) infection, it is possible that there will be increased use of mupirocin for nasal decolonization of MRSA. Understanding the mechanisms, clinical significance, and epidemiology of mupirocin resistance is important for predicting how changes in mupirocin use may affect bacterial populations and MRSA control. High-level mupirocin resistance in S. aureus is mediated by a plasmid-encoded mupA gene. This gene can be found on conjugative plasmids that carry multiple resistance determinants for other classes of antimicrobial agents. High-level resistance has been associated with decolonization failure, and increased resistance rates have been associated with increased mupirocin use. Low-level mupirocin resistance is mediated via mutation in the native ileS gene, and the clinical significance of this resistance is unclear. Laboratory tests to detect and distinguish between these types of resistance have been described but are not widely available in the United States. Institutions that are considering the implementation of widespread mupirocin use should consider these resistance issues and develop strategies to monitor the impact of mupirocin use.

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Section: Treatment and Prevention Of Community-associated Infectionmentioning

confidence: 99%

Section: Will Mupirocin Resistance Become More Prevalent In the Unitementioning

confidence: 99%

Section: Will Mupirocin Resistance Become More Prevalent In the Unitementioning

confidence: 99%

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Mupirocin Resistance

2009

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“…This, along with the increased use of mupirocin for prevention of recurrent skin and soft tissue MRSA infections (47)(48)(49), and growing interest in perioperative eradication of MRSA for the prevention of SSIs has important implications for the spread of mupirocin resistance (50). In 2002, Deshpande et al (51) performed an extensive study of mupirocin resistance and noted a marked increase globally compared to an earlier study.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Skin and Nasal Povidone-Iodine Preparation against Mupirocin-Resistant Methicillin-Resistant Staphylococcus aureus and S. aureus within the Anterior Nares

Anderson

David

Scholz

et al. 2015

Antimicrob Agents Chemother

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[BN]) or left untreated. One hour posttreatment, explants were washed with phosphate-buffered saline (PBS) plus 2% mucin. One, 6, or 12 h later, bacteria were recovered and enumerated. Alternatively, following baseline sampling, human subjects applied two consecutive applications of SNP or saline to their anterior nares. One, 6, and 12 h after application of the preparation (postprep), nasal swabs were obtained, and S. aureus was enumerated. We observed that treatment of infected PM or human skin explants with SNP resulted in >2.0 log 10 CFU reduction in MRSA, regardless of mupirocin sensitivity, which was significantly different from the values for BN-and Bet-treated explants and untreated controls 1 h, 6 h, and 12 h after being washed with PBS plus mucin. Swabbing the anterior nares of human subjects with SNP significantly reduced resident S. aureus compared to saline 1, 6, and 12 h postprep. Finally, pretreatment of PM explants with SNP, followed by a mucin rinse prior to infection, completely prevented MRSA infection. We conclude that SNP may be an attractive alternative for reducing the bioburden of anterior nares prior to surgery.

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“…An Emerging Infections Network survey of the use of decolonization to prevent staphylococcal infections in various health care settings found that !20% of infectious diseases consultants work in hospitals that routinely use decolonization therapy for individuals with staphylococcal carriage, either for carrier patients undergoing elective surgery or for infection control of MRSA [122]. Nevertheless, these consultants often attempt to decolonize patients with MRSA furunculosis.…”

Section: Prevention Of Mrsamentioning

confidence: 99%

Serious Infections Caused by Methicillin‐ResistantStaphylococcus aureus

2010

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Although first identified just >4 decades ago, methicillin-resistant Staphylococcus aureus (MRSA) has undergone rapid evolutionary changes and epidemiologic expansion to become a major cause of nosocomial and community-acquired infections worldwide. Increasing resistance to vancomycin among MRSA strains in conjunction with availability of new antibiotics, including daptomycin and linezolid, have increased treatment choices but made clinical treatment decisions more challenging. This article describes the clinical features and management issues of 2 challenging-to-treat manifestations of MRSA infection, bacteremia and/or endocarditis and osteomyelitis. It also presents a brief review of community-associated MRSA infections and preventive strategies directed against MRSA.

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Use of Decolonization to Prevent Staphylococcal Infections in Various Healthcare Settings: Results of an Emerging Infections Network Survey

Cited by 13 publications

References 11 publications

Mupirocin Resistance

Mupirocin Resistance

Efficacy of Skin and Nasal Povidone-Iodine Preparation against Mupirocin-Resistant Methicillin-Resistant Staphylococcus aureus and S. aureus within the Anterior Nares

Serious Infections Caused by Methicillin‐ResistantStaphylococcus aureus

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