K-1711. A Randomized Trial of Admission Screening and Decolonization of Staphylococcus aureus Carriers to Prevent Nosocomial S. aureus Infections
Session: Slide Session: MRSA Screening and Decolonization: Does it Work and is it Cost-Effective?
Sunday, October 26, 2008: 12:00 AM
Room: Independence A (Grand Hyatt)
Background: Patients who carry Staphylococcus aureus (S. aureus) have an increased risk of developing nosocomial infections with this microorganism. Decolonization of nasal and extra-nasal sites on admission to hospital may reduce the risk of developing these infections. Methods: In a randomized, double-blind, placebo-controlled, multi-center trial we assessed whether identification of S. aureus carriers by real-time polymerase chain reaction (real-time PCR) on nasal specimens followed by prompt treatment with mupirocin nasal ointment and chlorhexidine gluconate medicated soap reduces the risk of nosocomial S. aureus infection in carriers. Results: From October 2005 to June 2007, 6771 patients were screened on admission to hospital. 917 S. aureus real-time PCR positive patients were included in the intention-to-treat analysis. S. aureus infection rate was 17/504 (3.4%) in the mupirocin/chlorhexidine treated patients, and 32/413 (7.7%) in the placebo treated group (relative risk for infection 0.42; 95% confidence interval 0.23-0.75). The largest effect was observed for deep surgical site infections (1.1% in the mupirocin/chlorhexidine treated group vs 4.9% in the placebo treated group, RR 0.23; 95%CI 0.09-0.62). Conclusions: The combination of rapid detection and prompt decolonization of S. aureus carriers with mupirocin ointment and chlorhexidine gluconate medicated soap upon admission to hospital significantly reduced the risk of nosocomial S. aureus infections, especially the risk of deep surgical site infections.
Adrienne Box1, Alex van Belkum, Prof2, Andreas Voss, MD, PhD3, Annet Troelstra1, Christina Vandenbroucke-Grauls, Professor, MD, PhD4, Diana Bogaers5, Heiman Wertheim6, Henri Verbrugh6, Ingeborg van der Tweel7, Jan Kluytmans, MD, Prof, PhD5, Lonneke Bode8, Margreet Vos6, Robert Roosendaal4 and  L. G. M. Bode, None., (1)University Medical Center, (2)Medical Microbiology, Erasmus University Medical Center, Rotterdam, Netherlands, (3)Radboud Univ. Med. Ctr., Nijmegen, Netherlands, (4)VU Medical Center, (5)Amphia Hospital, (6)Erasmus Medical Center, (7)University Utrecht, (8)Erasmus Medical Center, Rotterdam, Netherlands

Alex van Belkum is a biologist working in the Erasmus MC, Rotterdam, The Netherlands, Department of Medical Microbiology and Infectious Diseases. Van Belkum holds the chair of molecular microbiology and manages a research team of approximately 35 researchers (6 postdocs, 12 PhD students and 15 technicians and students). Van Belkum has published over 370 PubMed cited papers and he is editor in chief of the European Journal of Clinical Microbiology and Infectious Diseases.

Andreas Voss
February 14, 1961
Warstein, Germany
Canisius-Wilhelmina Hospital
Radboud University Medical Centre
CM& ID
Medical Microbiology
P.O.Box 9015 (C70)
P.O. Box 9101 (440 MMB)
NL 6500 CS Nijmegen
NL-6500 HB Nijmegen
Phone: +31-24-3657514
+31-24-3614615
e-mail: vossandreas@gmail.com
DEGREES
1997- PhD degree, Faculty of Medical Science, University of Nijmegen
1995 - Specialist registration Medical Microbiology in the Netherlands
1992 - Specialist Medical Microbiology in Germany
1989 - PhD degree, Faculty of Medical Science, Technical University of Munich
1987 - MD degree, Faculty of Medicine, Technical University of Munich, Germany
CURRENT POSITION
Head, Department of Infection Control and Hospital Epidemiology, Canisius-Wilhelmina Hospital and Radboud University Nijmegen Medical Centre
Professor of Infection Control, Radboud University Medical Centre, Nijmegen, The Netherlands
MEMBERSHIPS
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID)
- Hospital Infection Society, UK (HIS)
- Society for Healthcare Epidemiology of America (SHEA)
- American Society of Microbiology (ASM)
- International Society of Infectious Diseases (ISID)
- Workgroup Hospital-infection Epidemiology the Netherlands (ZIEN)
- Infectious Diseases Society of the Netherlands and Flanders (VIZ)
SPECIAL INTERESTS
- Epidemiology of multi-resistant nosocomial pathogens (MRSA, VRE)
- Systemic fungal infections
- Handhygiene
COUNCIL
Present or former editorial board member: Journal of Hospital Infection, Clinical Performance
and Quality Health Care, Infection, Clinical Microbiology and Infection, ACMA,
ESCMID Executive Committee member
ECCMID Programme Director
PUBLICATIONS
> 160 peer-reviewed journal publications
multiple book chapters