ABSTRACT
BACKGROUND: To evaluate efficacy of mupirocin ointment nasal application in prevention of MRSA ventilatory associated pneumonia (VAP). DESIGN: prospective, double-blind, randomized, clinical trial. PATIENTS: 48 consecutive intubated patients admitted in the Intensive Care Unit during a three month period. SETTING: University of Florence; Intensive Care. INTERVENTIONS: Randomized application of 2 ml of Mupirocin ointment three times a day for three days (Group A; n = 24) or placebo (Group B n = 24). STATISTIC: Chi 2 or Fisher exact test. MEASUREMENTS: Bacteriologic evaluation of nasal carriage at admission in ICU, and after 3 days of prevention; evaluation of bacteriology of bronchial aspirate in the case of symptoms of ventilatory associated pneumonia. RESULTS AND CONCLUSIONS: Relative risk of nasal carriage by pathological bacterial strains is 7.2 times in hospitalized patients more than in home patients (18/25 vs 7/23); MRSA nasal carriage is present at admission on 20% of hospitalized patients. Nasal carriage of Staphylococcus strains is reduced of 90% by Mupirocin application but is reduced only of 50% by placebo application (p < 0.05). In Group B, VAP occurred in 5 patients vs 3 of Group A; the more frequent incidence of VAP in group B is due to MRSA infection (p < 0.01) and it is related to MRSA nasal carriage.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Cross Infection/prevention & control , Mupirocin/therapeutic use , Pneumonia, Bacterial/prevention & control , Administration, Intranasal , Aged , Anti-Bacterial Agents/administration & dosage , Double-Blind Method , Female , Humans , Male , Middle Aged , Mupirocin/administration & dosage , Ointments , Prospective StudiesSubject(s)
Mezlocillin/therapeutic use , Respiratory Tract Infections/drug therapy , Acute Disease , Adult , Aged , Aged, 80 and over , Chronic Disease , Clinical Trials as Topic , Drug Evaluation , Female , Humans , Male , Middle AgedABSTRACT
The sensitivity of 200 bacterial strains, recently isolated from pathological products, has been determined in relation to 16 antibiotics both with the ABAC system and the agar diffusion method (Barry). Furthermore, the interference of the variation of inoculum in the ABAC system (controlled by numbering in Petri dishes) has been evaluated. This study presented a good general agreement of the results between both methods. Results of studies on the variation of inoculum (10(6)--10(7) CFU/ml) performance with the ABAC system, gave a very weak interference in the accuracy of the results (with the exception of a few bacterial species in relation to some antibiotics).
Subject(s)
Anti-Bacterial Agents/pharmacology , Bacteria/drug effects , Microbial Sensitivity Tests/methods , Microbial Sensitivity Tests/instrumentationABSTRACT
Whole blood, hair and fingernails of 80 representative subjects from the Province of Rome were analysed for total mercury. The mean value for whole blood was 0.020 mg/kg, for hair 0.51 mg/kg and for nails 1.08 mg/kg. Correlations were found (except for hair) between mercury levels and the number of fish meals, mercury amalgam dental fillings and residence (urban or rural) of the subjects examined. The levels found in hair appear to be influenced by external and individual pollution factors and thus unsuitable for any direct determination of the distribution in other organs of the human body.
