Kluytmans J A, Mouton J W, VandenBergh M F, Manders M J, Maat A P, Wagenvoort J H, Michel M F, Verbrugh H A
Department of Clinical Microbiology, University Hospital Rotterdam, The Netherlands.
Infect Control Hosp Epidemiol. 1996 Dec;17(12):780-5. doi: 10.1086/647236.
To test the hypothesis that perioperative elimination of nasal carriage of Staphylococcus aureus using mupirocin nasal ointment reduces the surgical-site infection (SSI) rate in cardiothoracic surgery.
Unblinded intervention trial with historical controls.
A university hospital, tertiary referral center for cardiothoracic surgery.
Consecutive patients undergoing cardiothoracic surgery between August 1, 1989, and February 1, 1991 (historical control group), and between March 1, 1991, and August 1, 1992 (intervention group).
The historical control group consisted of 928 patients and the intervention group of 868, of whom 752 actually were treated. The 116 patients who were unintentionally not treated were considered as a concurrent control group. In the intention-to-treat analysis, a significant reduction in SSI rate was observed after the intervention (historical-control group 7.3% and intervention group 2.8%; P < .0001). The SSI rate in the concurrent control group was significantly higher than in the treated group (7.8% and 2.0%, respectively; P = .0023). Resistance of S aureus to mupirocin was not observed.
The results of this study indicate that perioperative elimination of nasal carriage using mupirocin nasal ointment significantly reduces the SSI rate in cardiothoracic surgery patients and warrants a prospective, randomized, placebo-controlled efficacy trial. This preventive measure may be beneficial in other categories of surgical patients as well.
验证使用莫匹罗星鼻软膏在围手术期消除金黄色葡萄球菌鼻腔定植可降低心胸外科手术部位感染（SSI）率这一假设。
采用历史对照的非盲干预试验。
一所大学医院，心胸外科三级转诊中心。
1989年8月1日至1991年2月1日期间接受心胸外科手术的连续患者（历史对照组），以及1991年3月1日至1992年8月1日期间接受手术的患者（干预组）。
历史对照组有928例患者，干预组有868例，其中752例实际接受了治疗。116例未接受治疗的患者被视为同期对照组。在意向性分析中，干预后SSI率显著降低（历史对照组为7.3%，干预组为2.8%；P < .0001）。同期对照组的SSI率显著高于治疗组（分别为7.8%和2.0%；P = .0023）。未观察到金黄色葡萄球菌对莫匹罗星耐药。
本研究结果表明，使用莫匹罗星鼻软膏在围手术期消除鼻腔定植可显著降低心胸外科手术患者的SSI率，值得进行一项前瞻性、随机、安慰剂对照的疗效试验。这种预防措施可能对其他类别的手术患者也有益。
