Efficacy of Staphylococcus aureus nasal decolonization at hospital admission on reduction of any infections within 90 days - a systematic review and meta-analysis.
Thomas C Scheier, Peter W Schreiber, Xiaomei Yao, John W Eikelboom, Silvio D Brugger, Dominik Mertz
{"title":"Efficacy of Staphylococcus aureus nasal decolonization at hospital admission on reduction of any infections within 90 days - a systematic review and meta-analysis.","authors":"Thomas C Scheier, Peter W Schreiber, Xiaomei Yao, John W Eikelboom, Silvio D Brugger, Dominik Mertz","doi":"10.1016/j.jhin.2025.01.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Infections with Staphylococcus aureus (S. aureus) are associated with excess mortality and costs. Simple interventions, such as decolonization protocols, might help to reduce subsequent infections, especially in settings in which S. aureus is of major clinical relevance, such as healthcare-associated infections.</p><p><strong>Aim: </strong>To determine if S. aureus decolonization protocols, using a nasal ointment and applied at hospital admission, reduce the risk of infection.</p><p><strong>Search methods: </strong>MEDLINE, EMBASE and clinicaltrials.gov were searched for all randomized controlled trials investigating the use of nasal ointments for decolonization for patients at hospital admission and reporting on infections within 90 days. Data were pooled as risk ratios using a random-effects model. The Cochrane RoB 2 tool and GRADE were used to assess the risk of bias and quality of evidence.</p><p><strong>Results: </strong>Four (0.5%) of 833 screened studies with a total of 4,150 patients met eligibility criteria. The overall certainty of evidence ranged from low to moderate across outcomes. Nasal S. aureus decolonization likely reduces infections (6.9% vs. 9.5%; rate ratio (RR): 0.73 (95%CI 0.57; 0.93)) and may increase microbiological eradication (82.7% vs. 55.2%; RR: 1.80 (95%CI 0.73; 4.44) compared to placebo. It may not reduce mortality (2.5 vs. 2.4; RR: 1.02 (95%CI 0.67; 1.54) but also not lead to increased adverse effects (0.7% vs 0.6%; RR: 1.01, 95% CI 0.45; 2.30). Results were consistent across subgroups and sensitivity analyses.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jhin.2025.01.017","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Infections with Staphylococcus aureus (S. aureus) are associated with excess mortality and costs. Simple interventions, such as decolonization protocols, might help to reduce subsequent infections, especially in settings in which S. aureus is of major clinical relevance, such as healthcare-associated infections.
Aim: To determine if S. aureus decolonization protocols, using a nasal ointment and applied at hospital admission, reduce the risk of infection.
Search methods: MEDLINE, EMBASE and clinicaltrials.gov were searched for all randomized controlled trials investigating the use of nasal ointments for decolonization for patients at hospital admission and reporting on infections within 90 days. Data were pooled as risk ratios using a random-effects model. The Cochrane RoB 2 tool and GRADE were used to assess the risk of bias and quality of evidence.
Results: Four (0.5%) of 833 screened studies with a total of 4,150 patients met eligibility criteria. The overall certainty of evidence ranged from low to moderate across outcomes. Nasal S. aureus decolonization likely reduces infections (6.9% vs. 9.5%; rate ratio (RR): 0.73 (95%CI 0.57; 0.93)) and may increase microbiological eradication (82.7% vs. 55.2%; RR: 1.80 (95%CI 0.73; 4.44) compared to placebo. It may not reduce mortality (2.5 vs. 2.4; RR: 1.02 (95%CI 0.67; 1.54) but also not lead to increased adverse effects (0.7% vs 0.6%; RR: 1.01, 95% CI 0.45; 2.30). Results were consistent across subgroups and sensitivity analyses.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
