Use of intranasal mupirocin to prevent methicillin-resistant **Staphylococcus aureus** infection in intensive care units

Muller, Arno; Talon, Daniel; Potier, Alexandre; Belle, Evelyne; Cappelier, Gilles; Betrand, Xavier

doi:10.1186/CC3512

Title

Use of intranasal mupirocin to prevent methicillin-resistant **Staphylococcus aureus** infection in intensive care units

Author

Muller, Arno

Talon, Daniel

Potier, Alexandre

Belle, Evelyne

Cappelier, Gilles

Betrand, Xavier

Abstract

Introduction Methicillin-resistant Staphylococcus aureus (MRSA) causes severe morbidity and mortality in intensive care units (ICUs) worldwide. The purpose of this study was to determine whether intranasal mupirocin prophylaxis is useful to prevent ICU-acquired infections with MRSA. Materials and methods We conducted a 4-year observational retrospective study in a 15-bed adult medical ICU. During the first 2-year period mupirocin ointment was included in the MRSA control programme; during the second, mupirocin was not used. The main endpoint was the number of endogenous ICU-acquired infections with MRSA. Results The number of endogenous acquired infections was significantly higher during the second period than during the first (11 versus 1; P = 0.02), although there was no significant difference in the total number of patients infected with MRSA between the two periods. We also observed that nasal MRSA decolonisation was significantly higher in the mupirocin period than in mupirocin-free period (P = 0.002). Conclusion Our findings suggest that intranasal mupirocin can prevent endogenous acquired MRSA infection in an ICU. Further double-blind, randomised, placebo-controlled studies are needed to demonstrate its cost-effectiveness and its impact on resistance.

Language

English

Source (journal)

Critical care. - London

Publication

London : 2005

ISSN

1364-8535

1466-609X

DOI

10.1186/CC3512

Volume/pages