Nasal carriage of Staphylococcus aureus and cross-contamination in a surgical intensive care unit: efficacy of mupirocin ointment
| Autor: | C. Rouget, Y. Michel-Briand, P. Bailly, F. Barale, V. Cailleaux, Daniel Talon, Michelle Thouverez |
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| Rok vydání: | 1995 |
| Předmět: |
Microbiology (medical)
Staphylococcus aureus medicine.medical_specialty Micrococcaceae Colony Count Microbial Mupirocin medicine.disease_cause Group B law.invention Hospitals University Ointments chemistry.chemical_compound law Internal medicine medicine Humans Prospective Studies Administration Intranasal Cross Infection biology business.industry Incidence (epidemiology) Surgical wound General Medicine Staphylococcal Infections biology.organism_classification Intensive care unit Bacterial Typing Techniques Surgery Intensive Care Units Nasal Mucosa Infectious Diseases chemistry Carrier State Methicillin Resistance Nasal administration business |
| Zdroj: | Journal of Hospital Infection. 30:39-49 |
| ISSN: | 0195-6701 |
| Popis: | A six month prospective study was carried out in a surgical intensive care unit (SICU) of a university hospital to assess the incidence and routes of exogenous colonization by Staphylococcus aureus. A total of 157 patients were included in the study. One thousand one hundred and eleven specimens (nasal, surgical wound swabs, tracheal secretions obtained on admission and once a week thereafter, and all clinical specimens) were collected over a four month period from patients without nasal decontamination (A). They were compared with 729 specimens collected over a two month period from patients treated with nasal mupirocin ointment (B). All S. aureus strains were typed by restriction fragment length polymorphism (RFLP) pulsed-field gel electrophoresis after SmaI macrorestriction. The nasal colonization rates on admission were 25.5 and 32.7% in groups A and B, respectively. Thirty-one untreated patients (31.3%) and three patients (5.1%) treated with nasal ointment, acquired the nasal S. aureus in the SICU (P = 0.00027). Nasal carriers were more frequently colonized in the bronchopulmonary tract (Bp) and surgical wound (Sw) (62%) than patients who were not nasal carriers (14%) (P < 0.00001). The patterns were identical for nasal, Bp and Sw strains from the same patient. RFLP analysis characterized seven epidemic strains of methicillin-resistant S. aureus (MRSA) which colonized 60% of group A and 9% of group B patients (P < 0.00001). The bronchopulmonary tract infection rate was reduced in group B (P = 0.032). In conclusion, in an SICU, nasal carriage of S. aureus appeared to be the source of endogenous and cross-colonization. The use of nasal mupirocin ointment reduced the incidence of Bp and Sw colonization, as well as the MRSA infection rate. |
| Databáze: | OpenAIRE |
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