There are plenty of articles out there detailing the use of mupirocin and chlorhexidine baths as a means of decolonizaiton. At the hospital I worked at we decolonized all patients with mupirocin and chlorhexidine undergoing elective procedures if nasal swabs came back positive. Here's the article if you are interested, "Evanston Northwestern Healthcare (ENH) is the recipient of this years John M. Eisenberg Patient Safety and Quality Award. ENH has been recognized for its methicillin-resistant Staphylococcus aureus (MRSA) Reduction Program Team.
Evanston Northwestern Healthcare was the first in the country to begin a universal MRSA surveillance program, swabbing all in-patients at its three hospitals for the MRSA bacteria beginning in 2005, well before any recommendations from state law-makers. The goal of the program was always to reduce the risk of MRSA infection to patients cared for by ENH and all our benchmarks were achieved by the end of the programs first year,said Lance Peterson, MD, FIDSA, FASCP, Epidemiologist and a founder of the MRSA program at Evanston Northwestern Healthcare. Everyone at ENH put a lot of effort into this initiative to benefit our patients, and it is really wonderful that ENH as a whole is recognized by this very prestigious award.
This award, sponsored by the National Quality Forum (NQF) and The Joint Commission, recognizes ENH for local innovation when it comes to patient safety. Evanston Northwestern Healthcares MRSA screening program involves performing nasal swabs for colonization during the hospital admission process. A new molecular diagnostic technique called a real-time PCR is used to quickly assess MRSA infection. This allows hospital staff to promptly identify and isolate infected patients.
At its three hospitals, ENH has been able to reduce MRSA infection rates by 60% within the first year of the program. Universal MRSA surveillance has also decreased the risk of other patients and staff becoming infected. Peterson indicates that The biggest risk for getting a MRSA infection is becoming colonized in the nose with it. Our program has successfully prevented nasal colonization of patients coming to ENH for their care. We want people to come here for their healthcare and not go home with something unexpected that will later cause an infection and the program is successful in doing just that.
The approach judged by the NQF to be easy to reproduce and cost effective in any organization, has the potential to have a positive impact on the nationally increasing mortality rates and rising costs associated with MRSA infections. Consequently, it would have a commensurate impact on the quality and safety of patient care.
Evanston Northwestern Healthcares MRSA Reduction Program Team will soon publish its findings in a peer reviewed journal. Members are offering an outreach program to long-term care facilities to help prevent MRSA infection. They are also consulting with various hospitals across the country on how to start similar MRSA surveillance programs.
The patient safety awards program, launched in 2002 by NQF and The Joint Commission, honors John M. Eisenberg, MD, MBA, former administrator of the Agency for Healthcare Research and Quality (AHRQ). Dr. Eisenberg was one of the founding leaders of the NQF and sat on its board of directors."
And keep in mind...MRSA produces mutated PBPs with low affinity for beta-lactam antibiotics (it's not because it can now produce beta-lactamases...or otherwise the anti-staph penicillins would work).
Sure you do!!! Bactroban ointment is oftentimes used to eradicate nasal colonization of S. aureus...it even comes in single-use intranasal tubes!
To the OP, you may be interested in reading this article:
Muller AA, Talon D, Potier A, Belle A, Cappelier G, Bertrand X. Use of intranasal mupirocin to prevent MRSA infection in intensive care units. Crit Care. 2005;9:R246R250.
There's a commentary in the same issue as well.
