Clinical Effectiveness of Mupirocin for Preventing Staphylococcus aureus Infections in Nonsurgical Settings: A Meta-analysis.
A systematic literature review and meta-analysis was performed to identify effectiveness of mupirocin decolonization in prevention of Staphylococcus aureus infections, among nonsurgical settings. Of the 15 662 unique studies identified up to August 2015, 13 randomized controlled trials, 22 quasi-experimental studies, and 1 retrospective cohort study met the inclusion criteria. Studies were excluded if mupirocin was not used for decolonization, there was no control group, or the study was conducted in an outbreak setting. The crude risk ratios were pooled (cpRR) using a random-effects model. We observed substantial heterogeneity among included studies (I(2) = 80%). Mupirocin was observed to reduce the risk for S. aureus infections by 59% (cpRR, 0.41; 95% confidence interval [CI], .36-.48) and 40% (cpRR, 0.60; 95% CI, .46-.79) in both dialysis and nondialysis settings, respectively. Mupirocin decolonization was protective against S. aureus infections among both dialysis and adult intensive care patients. Future studies are needed in other settings such as long-term care and pediatrics.
Department of Epidemiology, University of Iowa College of Public Health.|Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System.|Department of Internal Medicine, University of Iowa Carver College of Medicine.
Rajeshwari
R
Nair
Department of Epidemiology, University of Iowa College of Public Health.|Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System.|Department of Internal Medicine, University of Iowa Carver College of Medicine.
Eli N
EN
Perencevich
Hardin Library for Health Sciences, University of Iowa, Iowa City.
Amy E
AE
Blevins
Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System.|Department of Internal Medicine, University of Iowa Carver College of Medicine.
Michihiko
M
Goto
IDEAS Center, Veterans Affairs Salt Lake City Health Care System, Utah.
Richard E
RE
Nelson
Department of Epidemiology, University of Iowa College of Public Health.|Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System.|Department of Internal Medicine, University of Iowa Carver College of Medicine.
Marin L
ML
Schweizer
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006801:Humans; D007362:Intensive Care Units; D016712:Mupirocin / Q000627:therapeutic use*; D009666:Nose / Q000382:microbiology; D006435:Renal Dialysis; D013203:Staphylococcal Infections / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D016712:Mupirocin
S. aureus; decolonization; infection; mupirocin; nonsurgical