title: Decreasing methicillin-resistant Staphylococcus aureus surgical site infections with chlorhexidine and mupirocin.
abstract: BACKGROUND
  Surgical site infections (SSIs) associated with methicillin-resistant Staphylococcus aureus (MRSA) are a major complication of surgery. This study is part of a large infection control quality improvement effort to eliminate MRSA SSIs.
  
  
  METHODS
  This is an Institutional Review Board-approved, case-control study examining MRSA SSI rates before and after implementation of a facility-wide MRSA SSI prevention protocol in 2007. The protocol involved a 5-day course of intranasal mupirocin and nonrinse 2% chlorhexidine gluconate cloths.
  
  
  RESULTS
  In 2006, a total of 39 MRSA SSIs occurred after 9,976 procedures in patients who underwent orthopedic, vascular, cardiac, or neurosurgical procedures (rate = 0.39 per 100 procedures). The highest incidence occurred after cardiac surgery (rate = 1.24/100 procedures), and the lowest occurred after orthopedic surgery (rate = 0.28/100 procedures). In 2007, the MRSA SSI rate decreased to 20 of 9,818 procedures (rate = 0.20/100 procedures) in the 4 categories (P = .016; odds ratio, 1.92). In 2008, the MRSA SSI rate dropped again to 13 of 10,068 procedures (rate = 0.13/100 procedures) in the 4 categories (P = .0003; odds ratio, 3.04).
  
  
  CONCLUSIONS
  A 5-day course of intranasal mupirocin and nonrinse 2% chlorhexidine gluconate cloths may be beneficial in preventing MRSA SSIs in the non-general surgery population.
authors: Tampa General Hospital, Tampa, FL 33606, USA. pthompson@tgh.org
authors: Peggy
authors: P
authors: Thompson
authors: Sally
authors: S
authors: Houston
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D002710:Chlorhexidine / Q000627:therapeutic use*; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D017053:Infection Control; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D016712:Mupirocin / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin; D002710:Chlorhexidine