Edward J Septimus1. 1. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; Division of Internal Medicine, Texas A&M College of Medicine, Houston, TX. Electronic address: eseptimus@gmail.com.
Abstract
BACKGROUND: Surgical site infection (SSI) is one of the most common health care-associated infections. Staphylococcus aureus remains the most common etiologic agent causing SSIs. Studies confirm S aureus carriage increases the risk of S aureus SSIs. The purpose of this article is to review the strategies to reduce SSIs due to S aureus focusing on nasal decolonization. RESULTS: Published studies indicate screening patients for S aureus nasal carriage and decolonizing carriers during the preoperative period decreases the risk of S aureus SSIs in cardiac and orthopedic surgery. Mupirocin remains the best topical agent at eradicating nasal S aureus however, concerns over resistance have led to development of alternative agents. Nasal povidone-iodine, alcohol-based nasal antiseptic, and photodynamic therapy are promising new interventions, but more studies are needed. CONCLUSIONS: Short term nasal mupirocin is still the most studied and effective topical agent in eradicating S aureus nasal colonization. However, increasing mupirocin resistance remains an ongoing concern and newer agents are needed. Currently, preoperative S aureus decolonization often uses combination chlorhexidine gluconate bathing and nasal mupirocin considering that colonization of multiple body sites is commonly seen.
BACKGROUND: Surgical site infection (SSI) is one of the most common health care-associated infections. Staphylococcus aureus remains the most common etiologic agent causing SSIs. Studies confirm S aureus carriage increases the risk of S aureus SSIs. The purpose of this article is to review the strategies to reduce SSIs due to S aureus focusing on nasal decolonization. RESULTS: Published studies indicate screening patients for S aureus nasal carriage and decolonizing carriers during the preoperative period decreases the risk of S aureus SSIs in cardiac and orthopedic surgery. Mupirocin remains the best topical agent at eradicating nasal S aureus however, concerns over resistance have led to development of alternative agents. Nasal povidone-iodine, alcohol-based nasal antiseptic, and photodynamic therapy are promising new interventions, but more studies are needed. CONCLUSIONS: Short term nasal mupirocin is still the most studied and effective topical agent in eradicating S aureus nasal colonization. However, increasing mupirocin resistance remains an ongoing concern and newer agents are needed. Currently, preoperative S aureus decolonization often uses combination chlorhexidine gluconate bathing and nasal mupirocin considering that colonization of multiple body sites is commonly seen.
Authors: David S Allan; Maria Del Carmen Parquet; Kimberley A Savage; Bruce E Holbein Journal: Antimicrob Agents Chemother Date: 2020-02-21 Impact factor: 5.191
Authors: Robert Garcia; Sue Barnes; Roy Boukidjian; Linda Kaye Goss; Maureen Spencer; Edward J Septimus; Marc-Oliver Wright; Shannon Munro; Sara M Reese; Mohamad G Fakih; Charles E Edmiston; Martin Levesque Journal: Am J Infect Control Date: 2022-05-04 Impact factor: 4.303
Authors: Heidy C Martínez-Díaz; Sandra L Valderrama-Beltrán; Ana C Hernández; Silvia K Pinedo; Juan R Correa; Édgar G Ríos; Julie J Rojas; Yessica Y Hernández; Marylin Hidalgo Journal: Biomedica Date: 2020-05-01 Impact factor: 0.935