Eradication of MRSA from carriers by means of whole-body washing with an antiseptic in combination with mupirocin nasal ointment.
Patients who are infected or colonised by MRSA should be isolated. However, isolation is very costly in terms of time and work. In order to shorten the period of isolation, attempts are being made to eradicate this organism from patients by means of whole-body washing in addition to nasal mupirocin treatment. The effectiveness of such washes has not yet been adequately confirmed by studies. From September 1997 to August 1998, therefore, in a clinical trial of MRSA eradication, 28 patients were washed for a period of five days with a 1:1 diluted preparation based on octenidine dihydrochloride. At the same time, the nose was treated with mupirocin. Before washing was begun, on day 4 during washing and on days 1, 4 and 7 after washing was completed, smears were taken from each patient from the nose, pharynx, forehead hairline, groin, axilla and wounds, and in the case of women from the sub-mammary area. Elimination of the MRSA was achieved in 21 out of 28 cases; in four cases the washing was discontinued on account of skin redness, in three cases no elimination could be achieved during the control period. In order to ensure the success of eradication and to minimise skin reactions due to the washing, the wash procedure must be standardised, and decontamination controlled microbiologically. The study confirms that MRSA can be eradicated by means of washing with an antiseptic combined with mupirocin treatment.
Sloot
N
N
Institut für Med. Mikrobiologie und Hygiene, Klinikum der Stadt Ludwigshafen am Rhein GmbH, Germany.
Siebert
J
J
Höffler
U
U
D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001494:Baths; D002353:Carrier State / Q000517:prevention & control; D003428:Cross Infection / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods; D005260:Female; D006801:Humans; D007097:Imines; D008297:Male; D016106:Methicillin Resistance; D016712:Mupirocin / Q000008:administration & dosage*; D009296:Nasal Cavity / Q000382:microbiology; D009824:Ointments; D011725:Pyridines / Q000008:administration & dosage*; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents; D007097:Imines; D009824:Ointments; D011725:Pyridines; D016712:Mupirocin; C034213:octenidine