Reduction in Staphylococcus Aureus Wound Colonization by Using Nasal Mupirocin in Burn Patients

應用鼻部Mupirocin的塗抹以降低灼傷傷口對於金黃色葡萄球菌的感染

傅士榮(Shyh-Rong Fuh) ； 楊瑞永(Jui-Yung Yang) ； 張立言(Li-Yen Chang) ； 莊秀樹(Shiow-Shuh Chuang) ； 鄭明輝(Ming-Huei Cheng)

《中華民國重建整形外科醫學會雜誌》 7卷3期 (1998/09) Pp. 206-213

https://doi.org/10.7096/JPRSA.199809.0005

摘要

金黃色葡萄球菌是灼傷傷口最常被培養出的菌種之一。由於容易經由病人或相關醫護人員的接觸而感染，因此常造成燒傷病房內的流行。
Mupirocin是80年代以後的產物，許多研究證實，此藥物對金黃色葡萄球菌及其它G(+)菌種有相當好的療效，並曾被廣泛地使用在院內感染管制上。由於人體鼻黏膜是金黃色葡萄球菌主要聚集處，若能藉由鼻腔局部的塗抹，以降低金黃色葡萄球菌的菌落，將可減少許多感染的途徑。
長庚醫院燒傷中心自去年三月至六月間，選擇了52位病人做為樣本，其中28位除接受一般灼傷傷口治療外，還額外於鼻部塗抹mupirocin。經對照後，鼻部及傷口的金黃色葡萄球菌感染率皆有顯著降低。由於mupirocin的使用方法簡單，成本很低，臨床上也沒有發現特別的不適反應，因此我們認為選擇性地使用mupirocin於燒傷病患鼻部，將有助於降低金黃色葡萄球菌的感染。

並列摘要

Staphylococcus aureus is a leading cause of nosocomial infections, especially in burned wound. The nasal cavity is the main reservoir of S. aureus which may spread to the wound or transmit from one individual to another. Elimination of nasal carriage of S. aureus can be achieved by various topical antibiotics, however, mupirocin has been shown to be particularly effective.
The mupirocin regimen consists of the intranasal application of 2% mupirocin ointment, applied three times daily for first 5 days post-burn, and twice weekly thereafter. From March to June 1997, 28 consecutive burned patients (≧20% TBSA) treated with supplemented intranasal mupirocin were compared with 24 patients without mupirocin regimen. S. aureus colonization in nasal vestibules declined significantly in the study group. In patients receiving mupirocin, the S. aureus colonization rate of burned wound (25%) is lower than control group (56%) significantly but the difference is less striking in yeast and other G (-) bacteria.
The intranasal mupirocin is an effective treatment regimen in eradication of S. aureus nasal carriage. Routine decontamination of nasal carriers of the burned patients on admission can probably avoid the spread of S. aureus epidemics.

並列關鍵字

mupirocin ； staphylococcus aureus ； nasal carriage