Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Surgical Infections

Background:

• Nasal carriage of Staphylococcus aureus (S. aureus) increases the risk of surgical-site infections.
• Mupirocin ointment can reduce S. aureus nasal carriage and potentially prevent postoperative infections.

Purpose of the Study:

• To evaluate the efficacy of intranasal mupirocin in reducing S. aureus surgical-site infections.
• To determine if mupirocin prevents other nosocomial infections in surgical patients.

Main Methods:

• A randomized, double-blind, placebo-controlled trial was conducted.
• Patients undergoing various surgeries were enrolled and received either intranasal mupirocin or placebo.
• Intention-to-treat analysis included 3864 patients.

Main Results:

• Overall S. aureus surgical-site infection rates were similar between mupirocin (2.3%) and placebo (2.4%) groups.
• Among S. aureus carriers, intranasal mupirocin significantly reduced nosocomial S. aureus infections (4.0% vs. 7.7% in placebo group; OR, 0.49; P=0.02).

Conclusions:

• Prophylactic intranasal mupirocin did not significantly lower overall S. aureus surgical-site infections.
• Mupirocin significantly decreased nosocomial S. aureus infections in patients identified as S. aureus carriers.