title: Clearance of nasal Staphylococcus aureus colonization with triple antibiotic ointment.
abstract: BACKGROUND
  The prevalence of Staphylococcus aureus colonization of healthcare workers is reported at 30%, with colonization rates for methicillin-resistant S aureus (MRSA) reported between 2.0% and 8.5% among industrialized nations. The anterior nares are the most frequent colonization site. Mupirocin is the standard of care for nasal S aureus decolonization, with decolonization rates as high as 90%. Staphyloccocal resistance to mupirocin has been described, requiring additional management strategies. In certain situations, triple antibiotic ointment (TAO) may be a suitable alternative for elimination of nasal S aureus colonization.
  
  
  METHODS
  Adult healthcare workers within an academic-centered hospital (n=216) were screened via nasal swab with culture for S aureus colonization. Forty-!ve subjects (20.8%) screened positive for S aureus; of these subjects, 3 (1.4%) were positive for MRSA. Of the 45 subjects with positive cultures, 30 completed 5 days of twice-daily intranasal TAO application. One week after treatment, all 30 subjects were reswabbed; 16 (53.3%) showed evidence of decolonization on repeat culture.
  
  
  CONCLUSIONS
  The rate of S aureus colonization of healthcare workers in our study is lower than published rates in industrialized nations. Intranasal application of TAO may be a viable option for eradication of nasal colonization by methicillin-susceptible S aureus in environments where mupirocin-resistant bacterial strains become more prevalent.
authors: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors: Elizabeth M
authors: EM
authors: Grossman
authors: Shivani
authors: S
authors: Nanda
authors: Jennifer R S
authors: JR
authors: Gordon
authors: Meghan
authors: M
authors: Dubina
authors: Alfred W
authors: AW
authors: Rademaker
authors: Dennis P
authors: DP
authors: West
authors: Peter A
authors: PA
authors: Lio
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001414:Bacitracin / Q000008:administration & dosage / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D009296:Nasal Cavity / Q000187:drug effects / Q000382:microbiology*; D009355:Neomycin / Q000008:administration & dosage / Q000627:therapeutic use; D009824:Ointments; D011112:Polymyxin B / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D009824:Ointments; D001414:Bacitracin; D009355:Neomycin; D011112:Polymyxin B