title: Pre-cesarean Staphylococcus aureus nasal screening and decolonization: a prospective randomized controlled trial.
abstract: OBJECTIVE
  Staphylococcus aureus (S. aureus) is a common pathogen in surgical site infections (SSIs). Mupirocin ointment is an effective treatment for nasal carriers. We aimed to investigate whether screening for nasal colonization of S. aureus and treating carriers prior to a cesarean section (CS) decreases the likelihood of SSI.
  
  
  METHODS
  This is a randomized controlled trial. All participants underwent nasal culture prior to the CS. Nasal carriers of S. aureus were treated with Mupirocin ointment according to a standardized protocol. In the control group, nasal cultures were obtained immediately prior to surgery and carriers were not treated.
  
  
  RESULTS
  We recruited 568 patients. Demographic characteristics were comparable between the groups. S. aureus nasal colonization rates were 20.1% and 14.9% in the intervention and control groups, respectively (p = 0.12). S. aureus eradication rate with Mupirocin treatment was 88%. SSI rates were similar in the intervention and control groups (13.1% versus 12.1%, respectively, p = 0.78) and in treated carriers, untreated carriers, and non-carriers (7.4% versus 13.0% versus 13.1%, respectively, p = 0.69). Previous CS was the only factor found to independently predict SSI (OR 2.5, CI 1.09-5.65 p = 0.029).
  
  
  CONCLUSIONS
  Pre-cesarean screening for nasal S. aureus carriage and decolonization does not appear to be an effective intervention in reducing SSI rates.
authors: a Department of Obstetrics & Gynecology , Hillel Yaffe Medical Center , Hadera , Israel and.
authors: Guy
authors: G
authors: Shrem
authors: b The Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology , Haifa , Israel.
authors: Tomer
authors: T
authors: Egozi
authors: a Department of Obstetrics & Gynecology , Hillel Yaffe Medical Center , Hadera , Israel and.
authors: Amir
authors: A
authors: Naeh
authors: a Department of Obstetrics & Gynecology , Hillel Yaffe Medical Center , Hadera , Israel and.|b The Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology , Haifa , Israel.
authors: Mordechai
authors: M
authors: Hallak
authors: a Department of Obstetrics & Gynecology , Hillel Yaffe Medical Center , Hadera , Israel and.|b The Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology , Haifa , Israel.
authors: Asnat
authors: A
authors: Walfisch
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002353:Carrier State / Q000188:drug therapy / Q000382:microbiology*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D016712:Mupirocin / Q000627:therapeutic use*; D009666:Nose / Q000382:microbiology; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D057234:Preoperative Period; D012044:Regression Analysis; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin
keywords: Cesarean section; Mupirocin; Staphylococcus aureus; nasal colonization; surgical site infection; wound infection