Ｍｕｐｉｒｏｃｉｎ鼻腔用軟膏の三次救急医療施設におけるＭＲＳＡ感染症発症防止効果の検討

Abstract

In the intensive care unit (ICU) for critical care, there is a high incidence of methicillin resistant Staphylococcus aureus (MRSA) outbreaks by cross infection when MRSA carriers happen to be in the ICU. A hospital infection of MRSA causes particular problems because of the high cost of treatment and prophylaxis. We examined the effects of mupirocin calcium hydrate nasal ointment (MUP) to eliminate MRSA infection by applying it to all patients who were admitted to our critical care ward. During the study period, a historical control phase, a placebo-controlled phase (phase-I) and a phase for blanket use of MUP (phase-II) lasted 4, 8, and 4 months, respectively. A significantly lower rate of MRSA infection in the group using MUP (n=243) was noted in comparison with the historical control group (n=121) (0.4% and 6.6% respectively; p=0.0110). In phase-I, only one MRSA infection was documented in the MUP group compared to 7 in the placebo group (p=0.025). An analysis of the costs showed a significant difference in the average cost of the drugs for MRSA infection per patient in the historical control period and phase-II (¥14, 698 and ¥376 respectively; p<0.0001). In conclusion, nasal decontamination using MUP on admission to the ICU for critical care was found to be effective in eliminating MRSA infections. In addition, this regimen was considered to be a cost-effective solution for the MRSA problem because of the significant reduction in the drug cost for MRSA infection.