S. aureus

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Prospective, Randomized Trial of S. <strong>aureus</strong> decolonization • Multicenter, prospective placebo controlled trial of 6,771 patients between 2005 and 2007 – Intervention was rtPCR screening with nasal mupirocin/chlorhexidine bath for positive patients • 808 positive patients had surgery – 4 deep infections (0.9%) occurred in the treated group – 16 infections (4.4%) occurred in the placebo group » RR 0.21; 95% CI = 0.07-0.62 – LOS 1.8 days shorter in the treated group (p=0.04) – Time to infection was shorter in the placebo group (p=0.005) LGM Bode et al. NEJM 362: 9-17, 2010
Summary • The nares is an essential site for staphylococcal colonization • Surveillance for S. <strong>aureus</strong> is helpful for preventing infection in the pre-surgical setting as well as for MRSA control • The role of active surveillance is most important when: – Clinical disease is significant – Colonization precedes clinical infection – Clonal spread is important in disease escalation
Page 1 and 2: The Skin Microbiome - Clinical Labo
Page 3 and 4: Objectives • Review the relevance
Page 5 and 6: Skin Ecology - Dominance • Propio
Page 7 and 8: Microbiome of the Nose • S. aureu
Page 9 and 10: Risk for S. aureus Infection • Sy
Page 11 and 12: Review of Mupirocin Decolonization
Page 13 and 14: CDC Surveillance (2005) • Prospec
Page 15 and 16: US Infection Mortality 2005 FR DeLe
Page 17 and 18: Percent Positive on Admission 25.0
Page 19 and 20: NorthShore MRSA Program Began on Au
Page 21 and 22: Includes all admissions (Community
Page 23 and 24: Medical and Economic Outcome • Ex
Page 25 and 26: Cluster Randomized Trial of ICU: De
Page 28 and 29: Changing Prevalence of S. aureus in
Page 30 and 31: Results of Preoperative Screening f

S. aureus

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