The eradication of MRSA nasal carrier status by mupirocin pomadeand the effect of eradication on the prevelance of MRSA infection

Abstract number: 1733_349

Irmak H., Cesur S., Yildiz F., Bulut C., Kinikli S., Aygün Z., Demiröz A.P.

Objectives: The aim of this study is to compare the rate of eradication of MRSA carrier status in hospital staff with mupirocin with placebo and to establish the effect of eradication on the prevalance of MRSA infection.

Methods: This study was carried out in Infectious Diseases and Clinical Microbiology Department of Ankara Training and Research Hospital.

Totally eigty-eight hospital staff, 44 of them in mupirocin grup (20 MRSA nasal carriers, 24 MSSA nasal carriers) and further 44 hospital staff, who are MSSA carriers and administered placebo as control group, were included in the study. Informed consent of the patients and approval of ethics committee was obtained. Control group received only placebo.

MRSA prevalance in the three months before administration of mupirocin and the prevalance in the three months following administration were calculated.

Mupirocin pomad was applied three times a day for 5 days to the nose. 6th day, 1 month and 2 months after application, nasal cultures from obtained form the staff applied muciporin and those receiving placebo and eradication rates established. and compared statistically. In statistical analysis Chi-square and Fisher's Exact tests were used.

Results: Eradication rates were found to be respectively 91.7%, 66.6% and 58.3% after 6 days, 1 month and 2 months in mupirocin group while they were 4.5%, 6.8% and 11.4% respecively in the control group. In the mupirocin group, resistance developed against mupirocin in 2 (4.5%) hospital staff. In another 6 (13.6%) hospital staff receiving mupirocin, side effects such as feeling of burning developed in the nose. After treatment ended, these complaints resolved spontaneously.

When the eradication rates at 6 days, 1 month and 2 months were compared between two groups, statistically significant difference was found (p < 0.001). While MRSA infection prevalence was 9.6% (12/125) in the three months before application of mupirocin, it was 6.8% (8/118) in the the three months after application., with no statistically significant difference (p > 0.05).

Conclusion: In conclusion, although the eradication of nasal carrier status of MRSA is higher with mupirocin compared with placebo, mupirocin per se is not adequate in the reductionof the prevalence of MRSA infection. In order to reduce the prevalance of MRSA infection, all infection control measures for MRSA infection (isolation, contact isolation, hand washing, laboratory based surveillance) and training of the staff are required.