Abstract
AimTo assess the effects of nasal decontamination on preventing surgical site infections (SSIs) in people who are Staphylococcus aureus carriers undergoing different types of surgeries and diverse measures of decolonization.MethodsRelevant randomized controlled trials (RCTs) were identified through systematic searches of the PubMed, Embase, Web of science, and the Cochrane Library databases. The risk ratios (RRs) and 95% confidence intervals (CIs) were calculated and the effects model was chosen according to the heterogeneity. Subgroup analyses were performed according to different types of surgeries and measures of decolonization that Staphylococcus aureus carriers were applied.ResultsTwenty RCTs published between 1996 and 2019 involving 10,526 patients were included. Pooled results showed that the overall SSIs and pulmonary surgery SSIs presented with a statistical difference in measures of nasal decontamination (RR = 0.59 and 0.47, respectively, both p < 0.01). However, the associations between nasal decolonization and increased risks of SSIs in orthopedics surgery or cardiovascular surgery remained insignificant in studies. As for the diverse measures of nasal decontamination, 50% used mupirocin, 15% used chlorhexidine, 30% used different types of antimicrobial drugs, and 5% use others. The SSIs rate were decreased after chlorhexidine (RR = 0.474, 95% CI 0.259–0.864), while no significant difference was shown in the use of mupirocin (RR = 0.871, 95% CI 0.544–1.394).ConclusionIt seems that nasal decolonization of Staphylococcus aureus may be associated with a reduction of SSIs in these patients, especially in patients who have been administered by pulmonary surgeries or treated with chlorhexidine.
Highlights
Staphylococcus aureus (S. aureus), which is normally presented in the microbiota of the human skin and is generally asymptomatic
Tang et al Ann Clin Microbiol Antimicrob (2020) 19:33 most common pathogen associated with a postoperative surgical site infections (SSIs), what remains unclear is the exact source of the pathogen [6]
The aim of the study is to evaluate the use of nasal decontamination in different types of surgery and provide some evidence that makes efforts to measure of infection control and prevention
Summary
Staphylococcus aureus (S. aureus), which is normally presented in the microbiota of the human skin and is generally asymptomatic. It remains one of the most common drug-resistant pathogens that causes infection in hospitalized patients [1, 2]. It has been shown that being a nasal carrier of S. aureus is a significant risk factor for developing a SSI [7]. In this regard, it seems that the number of SSIs acquired in hospitals may be reduced by decolonization of nasal S. aureus carriage on admission [8]. The aim of the study is to evaluate the use of nasal decontamination in different types of surgery and provide some evidence that makes efforts to measure of infection control and prevention
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