van Rijen Miranda M L, Bonten Marc, Wenzel Richard P, Kluytmans Jan A J W
Laboratory for Microbiology and Infection Control, Amphia Hospital, Location Molengracht, PO Box 90158, 4800 RK Breda, The Netherlands.
J Antimicrob Chemother. 2008 Feb;61(2):254-61. doi: 10.1093/jac/dkm480. Epub 2008 Jan 3.
The majority of nosocomial Staphylococcus aureus infections originate from the patients' own flora, with nasal carriage of S. aureus before surgical procedures being a risk factor for subsequent infection. The objective of this review was to assess whether intranasal mupirocin treatment of nasal S. aureus carriers before surgery results in a reduction of the post-operative S. aureus infection rate.
CENTRAL, EMBASE and MEDLINE were searched for the keywords mupirocin, pseudomonic acid or bactroban, combined with nasal or intranasal. Only randomized controlled studies investigating surgical patients were included. Titles and abstracts were screened independently by two reviewers. S. aureus infection data in nasal carriers with and without mupirocin treatment were pooled in the meta-analysis.
The literature search resulted in 211 hits, of which 4 articles met the inclusion criteria. Among the 686 mupirocin-treated surgical patients with S. aureus nasal carriage, there were 25 S. aureus infections (3.6%), compared with 46 (6.7%) in the controls (RR 0.55, 95% CI 0.34-0.89; P = 0.02).
Prophylactic intranasal mupirocin significantly reduced the rate of post-operative S. aureus infections among surgical patients who were S. aureus carriers.
大多数医院获得性金黄色葡萄球菌感染源自患者自身菌群，手术前鼻腔携带金黄色葡萄球菌是后续感染的一个危险因素。本综述的目的是评估术前对鼻腔携带金黄色葡萄球菌的患者进行鼻内莫匹罗星治疗是否能降低术后金黄色葡萄球菌感染率。
在CENTRAL、EMBASE和MEDLINE数据库中检索莫匹罗星、假单胞菌酸或百多邦，以及鼻腔或鼻内等关键词。仅纳入调查手术患者的随机对照研究。由两名审阅者独立筛选标题和摘要。在荟萃分析中汇总了接受和未接受莫匹罗星治疗的鼻腔携带者的金黄色葡萄球菌感染数据。
文献检索共获得211条结果，其中4篇文章符合纳入标准。在686例接受莫匹罗星治疗的鼻腔携带金黄色葡萄球菌的手术患者中，有25例发生金黄色葡萄球菌感染（3.6%），而对照组为46例（6.7%）（相对危险度0.55，95%可信区间0.34 - 0.89；P = 0.02）。
预防性鼻内使用莫匹罗星可显著降低鼻腔携带金黄色葡萄球菌的手术患者术后金黄色葡萄球菌感染率。
