Bode nasal decolonisation

Preventing surgical-site infections in nasal carriers of Staphylococcus aureus.

Bode LG, Kluytmans JA, Wertheim HF, et al. The New England journal of medicine 2010 · PMID 20054045 · doi:10.1056/nejmoa0808939

Randomised trialPreventionOperative technique & equipmentCitation checked

Question: Does rapid screening and decolonisation of Staphylococcus aureus nasal carriers reduce hospital-acquired S. aureus infection?
Design: Double-blind placebo-controlled multicentre RCT in Dutch hospitals.
Patients: Hospital patients (mostly surgical) identified as nasal S. aureus carriers on rapid PCR screening at admission.
Intervention: Mupirocin nasal ointment plus chlorhexidine body wash
Comparison: Placebo ointment and placebo body wash
Primary outcome: Hospital-acquired S. aureus infection
Key result: Decolonisation more than halved hospital-acquired S. aureus infection, with the largest effect on deep surgical site infection; mortality did not differ.
Limitations: All strains were methicillin-sensitive, and the population covered mixed specialties rather than orthopaedics alone.
Impact on practice: It underpins preoperative MRSA/MSSA screening and decolonisation pathways before elective arthroplasty in the UK.