Risk Factors for Methicillin-Resistant Staphylococcus aureus (MRSA) and Use of a Nasal Mupirocin Ointment in Oral Cancer Inpatients.
OBJECTIVE
Elimination of methicillin-resistant Staphylococcus aureus (MRSA) is of critical importance in oral and maxillofacial surgery because control is very difficult once infection of an oral tumor or oral wound with MRSA is established.


METHODS
We retrospectively investigated the risk factors for acquiring MRSA in 518 patients with oral cancer among 1,877 inpatients in our department between 1984 and 2005.


RESULTS
The patients with oral cancer demonstrated a high rate of MRSA colonization and infection (77.8%) relative to the population as a whole with MRSA isolated percentage in our department after 1991. The risk factors for MRSA in oral cancer patients are also related to systemic diseases and physiological and iatrogenic conditions, including cerebrovascular diseases (77.8%), peripheral arterial catheterization (69.2%), diabetes (50.0%), tracheotomy (50.0%), renal failure (50.0%), long-term broad-spectrum antibiotic use (45.7%), and malnutrition (43.3%). However, the highest risk of MRSA seems to be related to poor hygienic care.


CONCLUSIONS
Beginning in 1999, we implemented a strategy for reducing infection by MRSA that included nasal mupirocin ointment for patients at high risk of MRSA; since then, the detection rate has decreased. We suggest that the administration of nasal mupirocin ointment and provision of scrupulous hygienic care for high-risk patients are useful and effective measures for decreasing the incidence of MRSA infection.
Miyake
Minoru
M
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan. dentmm@kms.ac.jp
Ohbayashi
Yumiko
Y
Iwasaki
Akinori
A
Ogawa
Takaaki
T
Nagahata
Shunichiro
S
D000281:Administration, Intranasal; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D002406:Catheterization, Peripheral / Q000295:instrumentation; D002561:Cerebrovascular Disorders / Q000150:complications; D015169:Colony Count, Microbial; D048909:Diabetes Complications / Q000382:microbiology; D005500:Follow-Up Studies; D006801:Humans; D006920:Hygiene; D044342:Malnutrition / Q000150:complications; D016106:Methicillin Resistance; D009062:Mouth Neoplasms / Q000382:microbiology*; D016712:Mupirocin / Q000008:administration & dosage*; D009824:Ointments; D051437:Renal Insufficiency / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000150:complications / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development; D014140:Tracheotomy
D000900:Anti-Bacterial Agents; D009824:Ointments; D016712:Mupirocin