title: The evaluation of nasal mupirocin to prevent Staphylococcus aureus burn wound colonization in routine clinical practice.
abstract: BACKGROUND
  Staphylococcus aureus wound colonization frequently occurs in patients with burns and can cause impaired wound healing. Nasal mupirocin application may contribute to the reduction of burn wound colonization of endogenous origin, whereas colonization by the exogenous route can be reduced by blocking cross-infection from other sources. In this study we evaluated whether the implementation of routine treatment of patients and burn center personnel using nasal mupirocin ointment reduces S. aureus burn wound colonization.
  
  
  METHODS
  We composed three study groups, consisting of a control period (Control), a mupirocin period (MUP), in which patients with burns were all receiving nasal mupirocin at admission, and a mupirocin+personnel period (MUP+P), in which we also screened the burn center personnel and decolonized S. aureus carriers by nasal mupirocin.
  
  
  RESULTS
  The patients who carried S. aureus in their nose and did not have S. aureus burn wound colonization at admission were considered as patients susceptible for the use of nasal mupirocin. In these patients, the S. aureus burn wound colonization rate was the same in all study groups. S. aureus nasal carriage was a significant independent risk factor for burn wound colonization (OR: 3.3; 95% CI: 1.4-7.6) when analyzed within the three study groups.
  
  
  CONCLUSIONS
  Although S. aureus carriage is a significant risk factor for developing burn wound colonization, the routine use of nasal mupirocin did not contribute to a reduction of burn wound colonization.
authors.affiliation: Burn Center, Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands. Electronic address: mjaspers@rkz.nl.
authors.forename: M E H
authors.initials: ME
authors.lastname: Jaspers
authors.affiliation: Burn Center, Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands; Department of Surgery, University Medical Center Leiden, Leiden, The Netherlands.
authors.forename: R S
authors.initials: RS
authors.lastname: Breederveld
authors.affiliation: Burn Center, Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: W E
authors.initials: WE
authors.lastname: Tuinebreijer
authors.affiliation: Burn Center, Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands; Regional Laboratory of Public Health, Boerhaavelaan 26, 2035 RC Haarlem, The Netherlands.
authors.forename: B M W
authors.initials: BM
authors.lastname: Diederen
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002053:Burn Units; D002056:Burns / Q000188:drug therapy*; D002353:Carrier State / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control*; D008875:Middle Aged; D016712:Mupirocin / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000517:prevention & control* / Q000635:transmission; D014946:Wound Infection / Q000517:prevention & control* / Q000635:transmission; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin
keywords: Burn wound colonization; Nasal carriage; Nasal mupirocin ointment; Staphylococcus aureus