Korean J Nosocomial Infect Control.  2001 Jun;6(1):33-40.

Prevention of Methicillin-Resistant Staphylococcus aureus Nasal carriage and Infection by Conventional Method and Intranasal Fusidic Acid

• Jung SI
• Heo ST
• Kim YS
• Kim S
• Peck KR
• Kwon OJ
• Joh JW
• Wi M
• Kang HY
• Lee JH
• Lee NY
• Kim OS
• Yoon SW
• Song JH

Abstract

BACKGROUND
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major pathogens of nosocomial infections. Especially in intensive care units (ICUs) and nasal carriage of Staphylococcus aureus has been known as a major risk factor of staphylococcal infections. In Korea, MRSA is the most common pathogen of nosocomial infections in ICUs. We performed this study to investigate the effects of conventional control measures and the additional effect of intranasal fusidic acid in prevention of MRSA nasal carriage and infection in ICUs of one educational hospital in Korea. METHOD: All patients admitted to medical ICU and surgical ICU in Samsung medical center from April to September 1999 were studied prospectively. Surveillance culture was done in all patients and health care workers by nasal swab culture. We tried to control MRSA infection by conventional methods in the first period April-June 1999) and by additional intranasal fusidic acid application in the second period (July-September 1999)
RESULTS
Comparing the first with second periods, new nasal MRSA colonization rate among patients was significantly decreased from 14.8% to 1.8% in surgical ICU (P=0.016). Although there was no statistical difference between the first and second periods in medical ICU (14.6% vs 5.9%, P=0.192), the new nasal colonization of the first period was significantly decreased than that of the previous study which was performed in 1996 (14.6% vs 36.2%, P=0.015). And new MRSA infection rate was much more decreased than the previous study, but there was no statistical significance (11.7% vs 2.0%, P=0.066).
CONCLUSION
Conventional methods for MRSA control decreased new MRSA nasal colonization of patients in ICUs. Application of intranasal fusidic acid was considered as an additional control measure for reducing MRSA nasal colonization. For evaluating effect of intranasal fusidic acid for preventing of MRSA infection in ICUs, further study with larger scale of study population is warranted.

Keyword

Methicillin-resistant Staphylococcus aureus; Intensive care unit; Nosocomial infection Nasal colonization; Fusidic acid

MeSH Terms

Colon
Cross Infection
Delivery of Health Care
Furosemide*
Fusidic Acid*
Humans
Intensive Care Units
Korea
Methicillin Resistance*
Methicillin-Resistant Staphylococcus aureus*
Prospective Studies
Risk Factors
Staphylococcal Infections
Staphylococcus aureus
Furosemide
Fusidic Acid