Efficacy evaluation of silver sulfadiazine nasal application for decolonizing hospitalized patients carring methicilin-resistant Staphylococcus aureus

• Grant number: 14/02637-9
• Support Opportunities: Regular Research Grants
• Start date: June 01, 2014
• End date: May 31, 2016
• Field of knowledge: Biological Sciences - Microbiology - Applied Microbiology
• Principal Investigator: Fernando Bellissimo Rodrigues
• Grantee: Fernando Bellissimo Rodrigues
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Associated researchers: Lécio Rodrigues Ferreira

Abstract

The health-care system is daily challenged by nosocomial infectious, which constitute a serious public health problem worldwide, increasing morbidity and mortality of patients and also hospital costs. Along with that, the exponential growing of drug-resistant bacteria in hospitals is a matter of concern to scientific community. Among these bacteria, we highlight the Methicillin-Resistant Staphylococcus aureus (MRSA), endemic in several health-care facilities in the world, and one of the main etiological agents of nosocomial infections. Previous nasal colonization is an important risk factor in the pathogenesis of infections caused by MRSA. Furthermore, it is known that colonized and infected patients represent an important reservoir of MRSA. Currently, decolonization of MRSA carriers is an important measure to control the spread of this bacterium. Mupirocin has been widely used for nasal decolonization of MRSA-colonized patients, however mupirocin-resistant strains of MRSA has becoming more frequent in the last decade. Moreover, the formulation of mupirocin available in Brazil is inadequate to mucous membranes application, often causing intolerable side effects. Since silver sulphadiazine has shown efficacy against MRSA in vitro, this study aim to assess the efficacy of intranasal application of silver sulfadiazine for the purpose of decolonize hospitalized patients carrying MRSA.We'll evaluate 100 hospitalized patients with MRSA nasal colonization which will be randomly selected to receive nasal decolonization therapy with silver sulphadiazine or placebo for 5 consecutive days. The primary outcome to be assessed is the rate of nasal MRSA decolonization, which will be compared between groups by use of chi-square, using the Pearson correction, or Fisher's exact two-tailed test. (AU)