Impact of prophylactic mupirocin for radical esophagectomy

https://doi.org/10.1007/s10156-006-0458-7Get rights and content

Abstract

The preoperative intranasal application of mupirocin significantly decreases the rate of nosocomial S. aureus infections among patients who are S. aureus carriers. However, it remains unclear whether the routine preoperative use of mupirocin would reduce postoperative S. aureus infections, especially methicillin-resistant Staphylococcus aureus (MRSA) infections, and who would benefit from the prophylactic use of mupirocin. Ninety-six consecutive patients who had undergone elective radical esophagectomy with right thoracotomy and laparotomy were evaluated. Fifty-one patients were given 2% mupirocin calcium ointment 3 times daily over 3 consecutive days before surgery. Uni- and multivariate analyses were performed to identify factors affecting the following three issues: postoperative MRSA infection, postoperative pneumonia, and the length of postoperative hospital stay. In univariate analyses, the preoperative application of mupirocin significantly reduced MRSA infection, postoperative pneumonia, and length of postoperative hospital stay. Multivariate analyses indicated significant associations between mupirocin administration and reductions in both MRSA infection and postoperative pneumonia, but not in length of postoperative hospital stay. Radical esophagectomy with right thoracotomy and laparotomy for esophageal carcinoma warranted the preoperative prophylactic administration of mupirocin in order to reduce postoperative infectious complications from MRSA. Its routine use for such a high-risk procedure is entirely reasonable.

References (32)

  • J. Kluytmans

    Reduction of surgical site infections in major surgery by elimination of nasal carriage of Staphylococcus aureus

    J Hosp Infect

    (1998)
  • T.M. Perl

    Prevention of Staphylococcus aureus infections among surgical patients: beyond traditional perioperative prophylaxis

    Surgery

    (2003)
  • M. Perez-Fontan et al.

    Mupirocin resistance after long-term use for Staphylococcus aureus colonization in patients undergoing chronic peritoneal dialysis

    Am J Kidney Dis

    (2002)
  • J.A. Kluytmans et al.

    Reduction of surgical site infections in cardiothoracic surgery by elimination of nasal carriage of S. aureus

    Infect Control Hosp Epidemiol

    (1996)
  • A.J. Gernaat-van der Sluis et al.

    Prophylactic mupirocin could reduce orthopedic wound infections

    Acta Orthop Scand

    (1998)
  • C.O. Solberg

    Spread of Staphylococcus aureus in hospitals: causes and prevention

    Scand J Infect Dis

    (2000)
  • Cited by (7)

    View all citing articles on Scopus
    View full text