REDUCTION IN STAPHYLOCOCCUS-AUREUS WOUND COLONIZATION USING NASAL MUPIROCIN AND SELECTIVE DECONTAMINATION OF THE DIGESTIVE-TRACT IN EXTENSIVE BURNS

Following the introduction in 1988 of a regimen of selective decontami nation of the digestive tract (SDD) for extensively injured patients i n our burns centre, colonization rates with Gram-negative organisms de clined significantly, but colonization with Staphylococcus aureus was unaffected. In an effort to reduce staphylococcal colonization, the SD D regimen has been supplemented with intranasal mupirocin since 1991. In this paper, 33 consecutive patients with burns of > 30 per cent TBS A who were treated with the supplemented regimen (SDD + M) in 1991 and 1992, were compared with 34 consecutive patients admitted in the prev ious 2 years who were treated with SDD only. Staph. aureus colonizatio n of wounds, sputum and gastric aspirates was significantly reduced in the SDD + M group. Gram-negative colonization rates and the incidence of clinical infections remained low in both groups. Our experience su ggests that decontamination of endogenous bacterial reservoirs, in com bination with isolation measures to prevent exogenous colonization, ef fectively prevents infectious complications in patients with severe bu rns.