title: Eradication of MRSA in chronic wounds of outpatients with leg ulcers is accelerated by antiseptic washes--results of a pilot study.
abstract: Whereas several studies evaluate MRSA in inpatients, for outpatients there are merely expert recommendations, but no systematic studies. Mostly, MRSA in outpatients is tolerated but not eradicated. Particularly, for risk patients with chronic wounds some experts postulate that MRSA-eradication is even impossible. For the first time, this pilot study systematically searched for the results of an eradication of MRSA in chronic leg ulcers of outpatients. 38 outpatients with a MRSA colonized leg ulcer were included in the survey and retrospective data analysis. Additionally to a wound therapy with silver-containing wound dressings, all patients were recommended to apply antiseptic eradication measures in accordance with the recommendations for inpatient treatment. MRSA was considered to be persistent, if it was detectable in the wound after at least one month of recommended eradication therapy. In 16 patients the MRSA could be successfully eradicated (MRSA-E), in 22 it could not (MRSA-P). Results showed a significant benefit of antiseptic body washes during the decontamination (MRSA-E 62.5%, MRSA-P 22.7%; p=0.0082). Other antiseptic measures like daily change of clothes and linen or disinfections of personal things and surroundings did not show significance. In conclusion, this pilot study shows that eradication of MRSA in chronic wounds is possible in outpatients. Antiseptic measurements, even administered by the patients themselves, seem to have a positive influence. Their efficacy has to be proven in larger, placebo-controlled studies for outpatient eradication.
authors.affiliation: Department of Dermatology, Vein Centre of the Departments of Dermatology and Vascular Surgery of the Ruhr University Bochum, Bochum, Germany. s.reich@elis-stiftung.de
authors.forename: Stefanie
authors.initials: S
authors.lastname: Reich-Schupke
authors.forename: Katharina
authors.initials: K
authors.lastname: Warneke
authors.forename: Peter
authors.initials: P
authors.lastname: Altmeyer
authors.forename: Markus
authors.initials: M
authors.lastname: Stücker
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000150:complications / Q000382:microbiology*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D010045:Outpatients; D010865:Pilot Projects; D013203:Staphylococcal Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local