Microbiological effect of mupirocin and chlorhexidine for Staphylococcus aureus decolonization in community and nursing home based adults

Diagn Microbiol Infect Dis. 2017 May;88(1):53-57. doi: 10.1016/j.diagmicrobio.2017.02.005. Epub 2017 Feb 13.

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.

Keywords: Chlorhexidine; Humans; Methicillin-resistant Staphylococcus aureus; Microbiology; Mupirocin; Nursing homes.

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Carrier State / drug therapy*
  • Carrier State / microbiology*
  • Chlorhexidine / administration & dosage*
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology
  • Cross Infection / drug therapy
  • Cross Infection / microbiology
  • Female
  • Gram-Negative Bacterial Infections / microbiology
  • Gram-Positive Asporogenous Rods / drug effects
  • Gram-Positive Asporogenous Rods / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Mupirocin / administration & dosage*
  • Nose / microbiology
  • Nursing Homes
  • Pharynx / microbiology
  • Prospective Studies
  • Skin / microbiology
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / drug effects*
  • Staphylococcus aureus / isolation & purification
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Mupirocin
  • Chlorhexidine