- When parents of neonatal ICU (NICU) infants are treated with intranasal mupirocin and chlorhexidine-soaked cloths for Staphylococcus aureus colonization, infant colonization decreases.
- Results of this preliminary trial require replication.
Why this matters
- Editorial calls the study “bold and innovative” but warns that generalizability is not clear.
- 40.0% (76/190) of infants had S aureus colonization at 90 days.
- Of this group, 55.2% (42/76) had a strain identified in parent samples.
- 33.7% (30/89) in the intervention group were S aureus colonized vs 45.5% (46/101) with placebo.
- HR, 0.57 (95% CI, 0.31-0.88).
- With the intervention, 14.6% (13/89) infants were colonized by a parent strain vs 28.7% (29/101) with placebo.
- Risk difference at 8 weeks, −14.1% (95% CI, −30.8% to −3.9%).
- HR, 0.43 (P=.03; meeting preplanned threshold for significance).
- 1 infant in each group developed S aureus infection before colonization.
- Skin reactions in parents: 4.8% intervention vs 6.2% placebo.
- Double-blinded, placebo-controlled randomized trial, 2 tertiary NICUs.
- Intervention: intranasal mupirocin and 2% chlorhexidine.
- Placebo was intranasal petroleum jelly and nonmedicated soap cloths.
- Funding: US Agency for Healthcare Research and Quality.
- Participating centers have comprehensive S aureus surveillance/decolonization programs, so generalizability is not clear.
- No adjustment for degree of parent interaction.