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Preoperative intranasal mupirocin ointment significantly reduces postoperative infection with Staphylococcus aureus
Abstract:
Nasal carriage of Staphylococcus aureus including methicillin-resistant S. aureus (MRSA) is associated with an increased risk for postoperative staphylococcal infection. This study was conducted to investigate the effect of preoperative nasal mupirocin treatment on the postoperative infections in patients undergoing upper gastrointestinal surgery. The intervention group consisted of 141 consecutive patients who underwent upper gastrointestinal surgery between March 1, 1997, and February 28, 1998. The patients in the intervention group were treated with intranasal mupirocin three times a day for 3 consecutive days before surgery. The incidence of postoperative staphylococcal infections in the intervention group was then compared with that of the historical control group. The control group consisted of 128 consecutive patients who underwent upper gastrointestinal surgery without mupirocin treatment between January 1, 1996 and December 31, 1996. The postoperative staphylococcal infection rate in the control group (11.7%) was significantly higher (P < 0.001) than in the intervention group (0.71%). The postoperative MRSA infection rate was significantly reduced by the intervention (control group 7.0% and intervention group 0%; P < 0.01). These results suggest that preoperative nasal eradication of S. aureus with mupirocin thus appears to be an effective measure to prevent postoperative staphylococcal infection in patients undergoing upper gastrointestinal surgery.
Insights
Preoperative nasal mupirocin treatment significantly reduced Staphylococcus aureus infections, including MRSA, in patients undergoing upper gastrointestinal surgery. This intervention effectively lowered postoperative infection rates, enhancing patient safety.
Area of Science:
- Surgical Infection Prevention
- Microbiology
- Clinical Medicine
Background:
- Nasal carriage of Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), elevates the risk of postoperative infections.
- Upper gastrointestinal surgery patients are susceptible to staphylococcal infections.
Purpose of the Study:
- To evaluate the efficacy of preoperative nasal mupirocin treatment in preventing postoperative staphylococcal infections.
- To assess the impact of mupirocin on MRSA infections in this surgical cohort.
Main Methods:
- A prospective study comparing an intervention group (n=141) receiving preoperative intranasal mupirocin with a historical control group (n=128) without treatment.
- Patients underwent upper gastrointestinal surgery.
- Infection rates were compared between the two groups.
Main Results:
- The overall postoperative staphylococcal infection rate was significantly lower in the mupirocin group (0.71%) compared to the control group (11.7%).
- Postoperative MRSA infection rates were dramatically reduced, from 7.0% in the control group to 0% in the intervention group.
- The reduction in infection rates was statistically significant (P < 0.001 for overall, P < 0.01 for MRSA).
Conclusions:
- Preoperative nasal mupirocin eradication of S. aureus is an effective strategy to prevent postoperative staphylococcal infections.
- This intervention significantly reduces the incidence of MRSA infections in patients undergoing upper gastrointestinal surgery.
- Mupirocin nasal treatment represents a valuable tool for improving surgical outcomes and patient safety.