Dose-Ranging Study To Assess the Application of Intranasal 2% Mupirocin Calcium Ointment To Eradicate<i>Staphylococcus aureus</i>Nasal Colonization

Mehta, Maitry S.; Hacek, Donna M.; Kufner, Bridget; Price, Connie S.; Peterson, Lance R.

doi:10.1089/sur.2012.086

Cited by 12 publications

(5 citation statements)

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“…Patients with positive results likely carried the microbe even though the nasal culture was negative at the time of sample collection, which increases the sensitivity of PCR and decreases the performance of culture. Mehta and colleagues 36 have documented that a single course of mupirocin decolonization keeps the nares culture free of S aureus, but this is no assurance that the effect is maintained beyond 30 days since that was the longest period they studied. However, decolonization can affect laboratory testing, making it reasonable to assume a positive PCR assay is accurate in the setting where MRSA-colonized patients are routinely treated with mupirocin.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Multiple Real-Time PCR Tests on Nasal Samples in a Large MRSA Surveillance Program

Patel

Robicsek

Grayes

et al. 2015

American Journal of Clinical Pathology

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Section: Discussionmentioning

confidence: 99%

Evaluation of Multiple Real-Time PCR Tests on Nasal Samples in a Large MRSA Surveillance Program

Patel

Robicsek

Grayes

et al. 2015

American Journal of Clinical Pathology

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“…In Part I and II study of Mehta et al ., patients had intranasal swab cultures performed 3 weeks prior to surgery screening for MRSA; if positive, they were also followed for 4 postoperative weeks. [26] Part 1 MRSA-positive patients had to apply 2% mupirocin twice a day for 2, 3, or 5 days; they were recultured up to 4 weeks postoperatively. In Part II, all 60 patients only received 5 days of mupirocin twice a day (10 doses) and again were cultured for up to 4 postoperative weeks.…”

Section: Introductionmentioning

confidence: 99%

Preoperative measures to prevent/minimize risk of surgical site infection in spinal surgery

Epstein¹

2018

Surg Neurol Int

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Background: Multiple measures prior to spine surgery may reduce the risks of postoperative surgical site infections (SSIs). Methods: The incidence of SSI following spinal surgery (including reoperations and readmissions) may be markedly reduced by performing less extensive procedures and avoiding fusion where feasible. Preoperative testing up to 3 weeks postoperatively should include other studies to limit the perioperative SSI risk; cardiac stress tests (e.g., older patients/cardiac comorbidities), starting tamsulosin in males over 60 (e.g. avoid urinary retention due to benign prostatic hypertrophy), albumin/prealbumin levels (e.g., low levels increase SSI risk), and HBA1C levels to identify new/treat known diabetics (normalize/reduce preoperative levels). Results: Other measures include the timely administration of preoperative antibiotics (e.g., cefazolin 2 g nonpenicillin allergic), one dose of gentamicin (adjusted dose/weight), nasal cultures for methicillin-resistant Staphylococcus aureus (patients/health-care workers), and bathing 2 weeks preoperatively with chlorhexidine gluconate 4% (not just night before/morning of surgery). Additionally, prior to surgery, the following medications that increase the bleeding risk should be stopped (e.g. for varying periods); anticoagulants, antiplatelet therapies (e.g., aspirin for at least 7–10 days), nonsteroidal anti-inflammatories (NSAIDS: timing depends on the drug), vitamin E, and herbal supplements. Additionally, avoiding elective spinal surgery in morbidly obese patients and recognizing other major medical contraindications to spinal surgery should help reduce infection, morbidity, and mortality rates. Conclusions: Appropriate preoperative and intraoperative prophylactic maneuvers may reduce the risk of postoperative spinal SSI. Specific attention to these details may avoid infections and improve outcomes.

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“…Successful nasal decolonization of S. aureus is difficult to achieve, and S. aureus readily recolonizes the nose, the throat and other sites within one week, commonly with the same S. aureus genotype [8–11]. Today, nasal mupirocin is the most efficacious regimen of S. aureus eradication from the anterior nares [12, 13]. However, the success rate for eradication of MRSA is low 12 months after decolonization [14].…”

Section: Introductionmentioning

confidence: 99%

Localization of Staphylococcus aureus in tissue from the nasal vestibule in healthy carriers

et al. 2017

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BackgroundColonization of the body is an important step in Staphylococcus aureus infection. S. aureus colonizes skin and mucous membranes in humans and several animal species. One important ecological niche of S. aureus is the anterior nares. More than 60% of the S. aureus in the nose are found in vestibulum nasi. Our aim was to describe the localization of S. aureus in nasal tissue from healthy carriers.MethodsPunch skin biopsies were taken from vestibulum nasi from healthy volunteers (S. aureus carriers and non−/intermittent carriers, n = 39) attending the population-based Tromsø 6 study. The tissue samples were processed as frozen sections before immunostaining with a specific S. aureus antibody, and finally evaluated by a confocal laser-scanning microscope.ResultsOur results suggest that S. aureus colonize both the upper and lower layers of the epidermis within the nasal epithelium of healthy individuals. The number of S. aureus in epidermis was surprisingly low. Intracellular localization of S. aureus in nasal tissue from healthy individuals was also detected.ConclusionsKnowledge of the exact localization of S. aureus in nasal tissue is important for the understanding of the host responses against S. aureus. Our results may have consequences for the eradication strategy of S. aureus in carriers, and further work can provide us with tools for targeted prevention of S. aureus colonisation and infection.Electronic supplementary materialThe online version of this article (doi:10.1186/s12866-017-0997-3) contains supplementary material, which is available to authorized users.

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Dose-Ranging Study To Assess the Application of Intranasal 2% Mupirocin Calcium Ointment To EradicateStaphylococcus aureusNasal Colonization

Abstract: The ten-dose regimen is superior to any six-dose regimen for de-colonizing S. aureus from the anterior nares of patients and for maintaining the decolonized state for at least four weeks after therapy.

Cited by 12 publications

References 23 publications

Evaluation of Multiple Real-Time PCR Tests on Nasal Samples in a Large MRSA Surveillance Program

Evaluation of Multiple Real-Time PCR Tests on Nasal Samples in a Large MRSA Surveillance Program

Preoperative measures to prevent/minimize risk of surgical site infection in spinal surgery

Localization of Staphylococcus aureus in tissue from the nasal vestibule in healthy carriers

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