title: Prophylactic mupirocin could reduce orthopedic wound infections. 1,044 patients treated with mupirocin compared with 1,260 historical controls.
abstract: We analyzed the effect of perioperative elimination of nasal carriage of Staphylococcus aureus using mupirocin nasal ointment on the reduction of the postoperative wound infection rate in orthopedics. In an unblinded intervention trial, we compared 1,044 patients treated with mupirocin (intervention group) with 1,260 historical controls (control group). From each group a random sample of 50 patients was taken. Risk factors were analyzed in these random samples and we found it unlikely that different distributions of risk factors might have influenced the results. The wound infection rates were 14/1,044 in the intervention group and 34/1,260 in the control group (p = 0.02). The rates of wound infections caused by S. aureus were subsequently 7/1,044 and 14/1,260 (p = 0.3). On checking the data we found that prophylaxis had unintentionally not been given to 172 patients in the intervention group. Correction of the data gave a comparable total infection rate, but a further reduced infection rate by S. aureus. Our findings suggest that prophylactic treatment with mupirocin in orthopedic surgery can reduce the infection rate.
authors.affiliation: Department of Medical Microbiology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Gernaat-van der Sluis
authors.forename: A M
authors.initials: AM
authors.lastname: Hoogenboom-Verdegaal
authors.forename: P J
authors.initials: PJ
authors.lastname: Edixhoven
authors.forename: N H
authors.initials: NH
authors.lastname: Spies-van Rooijen
mesh_terms: D000281:Administration, Intranasal; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002353:Carrier State / Q000517:prevention & control*; D005260:Female; D006801:Humans; D017053:Infection Control; D008297:Male; D016712:Mupirocin / Q000627:therapeutic use*; D009666:Nose / Q000382:microbiology*; D009824:Ointments; D019637:Orthopedic Procedures / Q000009:adverse effects*; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D009824:Ointments; D016712:Mupirocin