Hayakawa T, Hayashidera T, Katsura S, Yoneda K, Kusunoki T
Department of Pediatrics, Kyoto National Hospital, Japan.
Pediatr Int. 2000 Feb;42(1):67-70. doi: 10.1046/j.1442-200x.2000.01177.x.
Nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection in infants has become a serious concern and a new means of preventing the transmission of MRSA in the community needs to be considered.
We performed nasal mupirocin treatment on 10 infants who were MRSA-positive either in the nose or the pharynx and evaluated the effect of mupirocin on the eradication of MRSA.
Eradication of MRSA from the nose was successful in two cases and eradication from the pharynx in six (66.6%) of nine cases. The number of treatments required to achieve eradication varied; within three courses for nose carriers and from one to seven courses for pharynx carriers. Eradication was unsuccessful even after five to seven treatments in three pharynx-limited carriers.
These data suggest that the effect of nasal mupirocin treatment on pharynx-colonized MRSA is limited and that repetitive treatment is necessary in some cases. However, in view of the possibility of preferential pharyngeal colonization of Staphylococcus aureus in infancy, nasal mupirocin treatment deserves further evaluation for eradication not only of nose- but also of pharynx-colonized MRSA.
婴儿医院内耐甲氧西林金黄色葡萄球菌(MRSA)感染已成为一个严重问题,需要考虑一种预防社区中MRSA传播的新方法。
我们对10例鼻腔或咽部MRSA呈阳性的婴儿进行了鼻腔莫匹罗星治疗,并评估了莫匹罗星对根除MRSA的效果。
9例中有6例(66.6%)咽部MRSA根除成功,2例鼻腔MRSA根除成功。实现根除所需的治疗次数各不相同;鼻腔带菌者在三个疗程内,咽部带菌者在一至七个疗程内。3例仅咽部带菌者即使经过五至七次治疗根除仍未成功。
这些数据表明,鼻腔莫匹罗星治疗对咽部定植的MRSA效果有限,在某些情况下需要重复治疗。然而,鉴于婴儿期金黄色葡萄球菌优先在咽部定植的可能性,鼻腔莫匹罗星治疗不仅对根除鼻腔定植的MRSA,而且对根除咽部定植的MRSA都值得进一步评估。