title: Microbiological effect of mupirocin and chlorhexidine for Staphylococcus aureus decolonization in community and nursing home based adults.
abstract: OBJECTIVE
  To compare the presence of Staphylococcus aureus and pathogenic Gram-negative rods (GNR) in the anterior nares, posterior pharynx and three skin sites in community-based adults and nursing home-based adults before and after treatment with nasal mupirocin and topical chlorhexidine.
  
  
  METHODS
  S. aureus-colonized adults were recruited from the community (n=26) and from nursing homes (n=8). Eligible participants were cultured for S. aureus and GNR during two study visits and then received intranasal mupirocin and topical chlorhexidine for 5days, with a 2-month follow-up period.
  
  
  RESULTS
  After decolonization, we found sustained decreases of S. aureus colonization in nose, throat and skin sites over 4-8weeks in both populations. Intranasal mupirocin did not increase GNR colonization in nose or throat. Chlorhexidine did not decrease GNR colonization in skin sites.
  
  
  CONCLUSIONS
  Decolonization with mupirocin and chlorhexidine leads to a sustained effect on S. aureus colonization without affecting GNR colonization.
authors.affiliation: Geriatrics Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, MD, 21201; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, 21201. Electronic address: mroghman@epi.umaryland.edu.
authors.forename: Mary-Claire
authors.initials: MC
authors.lastname: Roghmann
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, 21201.
authors.forename: Alison D
authors.initials: AD
authors.lastname: Lydecker
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, 21201.
authors.forename: Patricia
authors.initials: P
authors.lastname: Langenberg
authors.affiliation: Department of Microbiology and Immunology and Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, 21201.
authors.forename: Emmanuel F
authors.initials: EF
authors.lastname: Mongodin
authors.affiliation: Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, 21201.
authors.forename: J Kristie
authors.initials: JK
authors.lastname: Johnson
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002353:Carrier State / Q000188:drug therapy* / Q000382:microbiology*; D002710:Chlorhexidine / Q000008:administration & dosage*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology; D006093:Gram-Positive Asporogenous Rods / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D016712:Mupirocin / Q000008:administration & dosage*; D009666:Nose / Q000382:microbiology; D009735:Nursing Homes; D010614:Pharynx / Q000382:microbiology; D011446:Prospective Studies; D012867:Skin / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin; D002710:Chlorhexidine
keywords: Chlorhexidine; Humans; Methicillin-resistant Staphylococcus aureus; Microbiology; Mupirocin; Nursing homes