Review
The significance of nasal carriage of Staphylococcus aureus and the incidence of postoperative wound infection

https://doi.org/10.1016/0195-6701(95)90079-9Get rights and content

Abstract

Staphylococcus aureus infections are associated with considerable morbidity and, in certain situations, mortality. The association between the nasal carriage of S. aureus and subsequent infection has been comprehensively established in a variety of clinical settings, in particular, patients undergoing haemodialysis and continuous ambulatory peritoneal dialysis (CAPD), and in patients undergoing surgery. Postoperative wound infections are associated with a high degree of morbidity and represent an important medical issue. Until recently, eradication of S. aureus nasal carriage by various topical and systemic agents had proved unsuccessful. Mupirocin is a novel topical antibiotic with excellent antibacterial activity against staphylococci. Recent studies have demonstrated that intranasal administration of mupirocin is effective in eradicating the nasal carriage of S. aureus and in reducing the incidence of S. aureus infections in haemodialysis and CAPD patients. It has been suggested that sufficient evidence now exists to test the hypothesis that eradication of the carrier state in surgical patients preoperatively may reduce the incidence of S. aureus postoperative wound infections.

References (52)

  • MW Casewell et al.

    Minimal dose requirements for nasal mupirocin and its role in the control of epidemic MRSA

    J Hosp Infect

    (1991)
  • MW Casewell et al.

    The carrier state: methicillin-resistant Staphylococcus aureus

    J Antimicrob Chemother

    (1986)
  • FThC Willems

    Epidemiology of nasal carriage of Staphylococcus aureus

  • T Weinke et al.

    Association between Staphylococcus aureus nasopharyngeal colonisation and septicaemia in patients infected with the human immunodeficiency virus

    Eur J Clin Microbiol Infect Dis

    (1992)
  • MA Luzar et al.

    Staphylococcus aureus nasal carriage and infection in patients on continuous ambulatory peritoneal dialysis

    N Engl J Med

    (1990)
  • SJ Davies et al.

    Staphylococcus aureus nasal carriage, exit-site infection and catheter loss in patients treated with continuous ambulatory peritoneal dialysis

    Peritoneal Dial Int

    (1989)
  • VL Yu et al.

    Staphylococcus aureus nasal carriage and infection in patients on hemodialysis

    N Engl J Med

    (1986)
  • M Pérez-Fontán et al.

    Treatment of Staphylococcus aureus nasal carriers in continuous ambulatory peritoneal dialysis with mupirocin: long-term results

    Am J Kidney Dis

    (1993)
  • RP Wenzel

    Preoperative antibiotic prophylaxis

    N Engl J Med

    (1992)
  • JAJW Kluytmans et al.

    Nasal carriage of Staphylococcus aureus as a major risk factor for wound infections after cardiac surgery

    J Infect Dis

    (1995)
  • LG Tulloch

    Nasal carriage in staphylococcal skin infections

    BMJ

    (1954)
  • JW Chow et al.

    Staphylococcus aureus nasal carriage in hemodialysis patients

    Arch Intern Med

    (1989)
  • CJ Sewell et al.

    Staphylococcal carriage and subsequent infection in peritoneal dialysis patients

    J Am Med Assoc

    (1982)
  • D Kim et al.

    Staphylococcus aureus in patients on continuous ambulatory peritoneal dialysis

    Trans Am Soc Artif Intern Organs

    (1984)
  • R Sesso et al.

    Staphylococcus aureus skin carriage and development of peritonitis in patients on continuous ambulatory peritoneal dialysis

    Clin Nephrol

    (1989)
  • RW Haley et al.

    Identifying patients at high risk of surgical wound infection: a simple multivariate index of patients susceptibility and wound contamination

    Am J Epidemiol

    (1985)
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