Topical treatment with mupirocine/chlorexydine and long-term risk of methicillin-resistant Staphylococcus aureus infection
Abstract number: 1733_810
Pan A., Soavi L., Mondello P., Catenazzi P., Lorenzotti S., Signorini L., Testa S., Carnevale G., Carosi G.
Objective: To evaluate the long term effect of topical treatment with mupirocine and chlorexidine on the risk of colonisation/infection in patients with a previous microbiological isolation of MRSA.
Methods: This prospective study was carried out at the hospital of Cremona, an 850-bed community hospital, where a MRSA control programme including topical treatment was ongoing. All hospitalised patients identified as being MRSA positive and for whom data regarding topical treatment with 2% nasal mupirocine ointment and 4% chlorexydine baths/showers and shampoo for 5 days were available, were included in the study.
Results: from January 1, 1997 through July 30, 2006, we identified 1,000 MRSA positive patients, for a total of 1,101 admissions. Data regarding topical treatment were available for 768 patients (77%) for a total of 853 admissions: 479 (62%) were treated with mupirocine on their first admission while 289 (38%) where not. Sixty-three treated and 78 untreated patients died during the first admission. MRSA was identified during a second admission in 41/416 treated patients (9.9%) and in 35/211 untreated subjects (16.6%) (P = 0.02). Six patients, 4 previously treated and 2 not treated, had more than one admission. We observed 17 infections in treated patients (4%) as compared with 7 in the untreated group (3.3%) (P = 0.8). The 17 infections in treated patients were as follows: 7 blood-stream infections (BSI), 3 respiratory infections (RTI), 6 skin and soft tissue infections (SSTI), and 1 other infection. Untreated patients had 7 infections: 1 RTI, 4 SSTI, 2 other infections. No significant difference was observed for any type of infection between treated and untreated subjects (P > 0.1 in all cases).
Conclusions: Patients treated with topical mupirocine and chlorexydine have a reduced risk of being identified as MRSA positive during after previous infection or colonisation (P = 0.02). Despite this, no reduction in the overall risk of infection in the follow-up was identified among treated vs untreated subjects.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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