HAIs: Types and Pathogens

Povidone-iodine as an Alternative to Mupirocin for Nasal Decolonization

  • Posted: February 20, 2018
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Despite being recognized as a preventable cause of patient morbidity and mortality with nationally established reduction targets, an estimated 1.7 million healthcare-associated infections (HAIs) occur annually. A 2011 multi-state prevalence survey found that nearly 50% of HAIs are the result of surgical site infections (SSIs) and device-associated infections with Staphylococcus aureus (S.aureus) as the second most common HAI pathogen. S. aureus has been a target for HAI reduction efforts and an important strategy for the prevention of serious staphylococcal infections is the elimination of S. aureus nasal carriage.

For years, mupirocin (MO) has been the gold standard for nasal decolonization to combat SSIs and control transmission of methicillin-resistant S. aureus (MRSA). However, widespread adoption of MO has led to mupirocin-resistant strains of S. aureus and treatment failures, prompting a shift to antiseptics such as povidone-iodine for HAI prevention and antibiotic stewardship efforts. The efficacy, safety, patient satisfaction and cost data on povidone-iodine is compelling and is a promising alternative to mupirocin.

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