Efficacy of Mupirocin Ointment in Eradication of Staphylococcus aureus Nasal Carriage in Intensive Care Unit Staff and Patients

ABSTRACT           Background and Objectives: Staphylococcus aureus is one of the most common causes of morbidity and mortality among intensive care unit (ICU) patients. Nasal carriage is one of the main routs of S. aureus transmission between hospital personnel and patients. The objective of this study was to evaluate the efficacy of mupirocin ointment in eradication of nasal carriage of S. aureus in the ICU staff and patients of Panje-Azar hospital in Gorgan, Iran.           Methods: In the first three months of the study (January to March), the prevalence of S. aureus among ICU patients was determined by routine microbiological and biochemical testing. Nasal samples were taken from ICU staff and all patients recently admitted to the ICU. Mupirocin nasal ointment (2%) was applied for treatment of S. aureus nasal carriers. Post-treatment sampling was done after five weeks. During the next three months, the presence of S. aureus and rate of resistance to methicillin was evaluated in new patients admitted to the ICU using the method used previously.           Results: Of 60 samples from the ICU staff, seven (11.7%) samples were positive for S. aureus. Moreover, of 240 samples from the ICU patients, two samples were found as S. aureus-positive. Of the nine S. aureus-positive isolates, only two (22.2%) were methicillin-resistant S. aureus (MRSA). In the pre-intervention sampling, only five samples (2.8%) were identified as S. aureus, two of which were MRSA. However, treatment with mupirocin ointment eradicated nasal carriage of S. aureus and no isolate was found after the intervention.           Conclusion: Our finding showed that mupirocin nasal ointment is highly effective in eradication of S. aureus nasal carriage and subsequently contribute to reduction in frequency of nosocomial infections in the ICU.           Keywords: Intensive Care Units, Mupirocin, Nasal, Staphylococcus aureus.