A better approach against Staph

Scottsdale – A report in Medscape.com and originally published int he New England of Journal of Medicine, focuses attention on patients that are nasal carriers of Staphylococcus aureus and who are at increased risk for health care related infections.

“Nasal carriers of Staphylococcus aureus are at increased risk for health care–associated infections with this organism,” write Lonneke G.M. Bode, MD, from Erasmus University Medical Center in Rotterdam, the Netherlands, and colleagues. “Decolonization of nasal and extranasal sites on hospital admission may reduce this risk.”

The research was performed as a randomized, double-blind, placebo-controlled, multicenter trial and theorizes decolonization of nasal and extra-nasal sites on hospital admission may reduce the risk of post-operative infection. A total of 6771 patients were screened on admission. The research found, 1270 nasal swabs from 1251 patients were positive for Staph. They enrolled 917 of these patients in the intention-to-treat analysis and 808 (88.1%) underwent a surgical procedures.

The patients were divided into a treatment group, receiving mupirocin and chlorhexidine before surgery, and a placebo group, which received sham treatment.

The results of the study demonstrated a rate of Staph infection of 3.4% (17 of 504 patients) in the mupirocin and chlorhexidine group, as compared with 7.7% (32 of 413 patients) in the placebo group.  The effect of mupirocin–chlorhexidine treatment was significant and most pronounced for deep surgical-site infections. The research concluded the number of surgical-site Staph infections acquired in the hospital can be reduced by rapid screening and decolonizing of nasal carriers of Staph on admission.

This is interesting research and I wonder if it can be applied to outpatient plastic surgery? I already recommend Hibiclens for preoperative showers for major body contouring surgery and I find that it helps to reduce the risks of infection. I believe that in the future, a study looking specifically at these medications in Arizona plastic surgery would be extremely useful.