Limiting the Usage of Intranasal Mupirocin Does Impact the Rate of Staphylococcus Aureus Deep Sternal Wound Infections

2.50
Hdl Handle:
http://hdl.handle.net/10755/159035
Type:
Presentation
Title:
Limiting the Usage of Intranasal Mupirocin Does Impact the Rate of Staphylococcus Aureus Deep Sternal Wound Infections
Abstract:
Limiting the Usage of Intranasal Mupirocin Does Impact the Rate of Staphylococcus Aureus Deep Sternal Wound Infections
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2006
Author:Huesman, Laura, RN, BSN
P.I. Institution Name:The Christ Hospital
Title:Case Manager
Contact Address:Critical Care Nursing, 2139 Auburn avenue, Cincinnati, OH, 45219, USA
Contact Telephone:513-585-0924
Co-Authors:Mary R. Nicholson, RN, BSN, Manager
Purpose: To determine if limiting the use of prophylactic intranasal mupirocin and targeting treatment efforts towards carriers would decrease Staphylococcus aureus (S. aureus) sternal wound infections.

Theoretical/Conceptual Framework: The study was physiologically theory based using the chain of infection as the framework.

Subjects: All patients (1077) who underwent cardiac surgery over a 17-month period were enrolled as the prospective group. The historical comparator group (954) consisted of all patients who underwent cardiac surgery during the previous 16-month period.

Method: Each cardiac surgery patient was nasally cultured prior to the initial sternal incision, with the first dose of mupirocin given and continued every 12 hours. Culture results were finalized within 48 hours; mupirocin was discontinued if the culture was negative, and continued for seven days if culture was positive for S. aureus.

Results: Nasal cultures revealed a S. aureus carrier rate of 21%; of these 13.5% were methicillin resistant (MRSA) strains. These carriers received mupirocin for seven days. The non-carriers received mupirocin for only 48 hours. There was a significant decrease in S. aureus associated SSI rates from 1.68% to 0.37 % per 100 procedures (p< 0.006) over a 17-month period between the historical and prospective group. An unexpected outcome was the elimination of MRSA non-surgical isolates, which was previously found with the historical group, averaging 8-10 cases/year.

Conclusions: Identifying and treating S. aureus carriers with mupirocin does impact the rate of S. aureus surgical site infections with limited usage to address resistant strains. These findings have significant implications for decreasing hospital length of stay, post-op complications, hospital and patient costs, and improved patient outcomes. [Poster Presentation]
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleLimiting the Usage of Intranasal Mupirocin Does Impact the Rate of Staphylococcus Aureus Deep Sternal Wound Infectionsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159035-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Limiting the Usage of Intranasal Mupirocin Does Impact the Rate of Staphylococcus Aureus Deep Sternal Wound Infections</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Huesman, Laura, RN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The Christ Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Case Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Critical Care Nursing, 2139 Auburn avenue, Cincinnati, OH, 45219, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">513-585-0924</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">huesmala@healthall.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Mary R. Nicholson, RN, BSN, Manager</td></tr><tr><td colspan="2" class="item-abstract">Purpose: To determine if limiting the use of prophylactic intranasal mupirocin and targeting treatment efforts towards carriers would decrease Staphylococcus aureus (S. aureus) sternal wound infections.<br/><br/>Theoretical/Conceptual Framework: The study was physiologically theory based using the chain of infection as the framework. <br/><br/>Subjects: All patients (1077) who underwent cardiac surgery over a 17-month period were enrolled as the prospective group. The historical comparator group (954) consisted of all patients who underwent cardiac surgery during the previous 16-month period. <br/><br/>Method: Each cardiac surgery patient was nasally cultured prior to the initial sternal incision, with the first dose of mupirocin given and continued every 12 hours. Culture results were finalized within 48 hours; mupirocin was discontinued if the culture was negative, and continued for seven days if culture was positive for S. aureus. <br/><br/>Results: Nasal cultures revealed a S. aureus carrier rate of 21%; of these 13.5% were methicillin resistant (MRSA) strains. These carriers received mupirocin for seven days. The non-carriers received mupirocin for only 48 hours. There was a significant decrease in S. aureus associated SSI rates from 1.68% to 0.37 % per 100 procedures (p&lt; 0.006) over a 17-month period between the historical and prospective group. An unexpected outcome was the elimination of MRSA non-surgical isolates, which was previously found with the historical group, averaging 8-10 cases/year. <br/><br/>Conclusions: Identifying and treating S. aureus carriers with mupirocin does impact the rate of S. aureus surgical site infections with limited usage to address resistant strains. These findings have significant implications for decreasing hospital length of stay, post-op complications, hospital and patient costs, and improved patient outcomes. [Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-26T21:38:23Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:38:23Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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