Staphylococcus aureus nasal colonization in a nursing home: eradication with mupirocin

Area of Science:

• Infectious Diseases
• Geriatric Medicine
• Antimicrobial Stewardship

Background:

• Increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections and colonization in institutionalized older adults.
• Nasal colonization by S aureus is a risk factor for subsequent infections, particularly in vulnerable populations.
• Need for effective strategies to reduce S aureus colonization in healthcare settings.

Purpose of the Study:

• To evaluate the efficacy of topical mupirocin ointment in eradicating nasal colonization with S aureus.
• To assess the impact of mupirocin treatment on both methicillin-sensitive S aureus (MSSA) and MRSA nasal carriage.
• To determine the safety and tolerability of mupirocin for S aureus decolonization in nursing home patients.

Main Methods:

• Screening of 102 nursing home residents for S aureus nasal colonization.
• Treatment of colonized patients with mupirocin ointment applied intranasally twice daily for seven days.
• Follow-up assessments at one and two months to evaluate for recolonization.

Main Results:

• 38.2% of patients were colonized with S aureus (18 MSSA, 21 MRSA).
• Mupirocin treatment achieved a 91.4% eradication rate of nasal S aureus colonization.
• Recolonization occurred in a subset of patients within two months; mupirocin was well-tolerated.

Conclusions:

• Topical mupirocin ointment is a highly effective and safe option for eliminating nasal S aureus colonization in nursing home residents.
• The study demonstrates the potential of mupirocin for controlling S aureus carriage in institutionalized elderly populations.
• Further research may explore strategies to prevent recolonization and long-term efficacy.