Prevention of Surgical Site Infections: Decontamination With Mupirocin Based on Preoperative Screening for Staphylococcus aureus Carriers or Universal Decontamination?
| Autor: | Hetem, David J, Bootsma, Martin C J, Bonten, Marc J M, Sub Mathematical Modeling, Mathematical Modeling |
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| Přispěvatelé: | Sub Mathematical Modeling, Mathematical Modeling |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Staphylococcus aureus MRSA mupirocin decolonization mupA prophylaxis 030106 microbiology Mupirocin Review Nose medicine.disease_cause Models Biological Microbiology Ointments 03 medical and health sciences chemistry.chemical_compound Drug Resistance Bacterial Surgical site Taverne medicine Journal Article Humans Surgical Wound Infection Administration Intranasal Decontamination business.industry Chlorhexidine Preoperative screening Baths Staphylococcal Infections Mupirocin resistance Infectious Diseases chemistry lipids (amino acids peptides and proteins) business Surgical site infection medicine.drug |
| Zdroj: | Clinical Infectious Diseases, 62(5), 631. Univ. of Chicago Press Clinical Infectious Diseases, 62(5), 631. Oxford University Press |
| ISSN: | 1058-4838 |
| Popis: | Perioperative decolonization of Staphylococcus aureus nasal carriers with mupirocin together with chlorhexidine body washing reduces the incidence of S. aureus surgical site infection. A targeted strategy, applied in S. aureus carriers only, is costly, and implementation may reduce effectiveness. Universal decolonization is more cost-effective but increases exposure of noncarriers to mupirocin and the risk of resistance to mupirocin in staphylococci. High-level mupirocin resistance in S. aureus can emerge through horizontal gene transfer originating from coagulase-negative staphylococci (CoNS) and through clonal transmission. The current evidence on the occurrence of high-level mupirocin resistance in S. aureus and CoNS, in combination with the results of mathematical modeling, strongly suggests that the increased selection of high-level mupirocin resistance in CoNS does not constitute an important risk for high-level mupirocin resistance in S. aureus. Compared with a targeted strategy, universal decolonization seems associated with an equally low risk of mupirocin resistance in S. aureus. |
| Databáze: | OpenAIRE |
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