Open Access

Role of targeted and universal mupirocin‑based decolonization for preventing surgical‑site infections in patients undergoing cardiothoracic surgery: A systematic review and meta‑analysis

  • Authors:
    • Li Wang
    • Qi Ji
    • Xiaoyan Hu
  • View Affiliations

  • Published online on: February 25, 2021     https://doi.org/10.3892/etm.2021.9860
  • Article Number: 416
  • Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The purpose of the present study was to provide a systematic literature review and pool evidence on the efficacy of mupirocin‑based decolonization protocol in reducing surgical‑site infections (SSIs) in patients undergoing cardiothoracic (CT) surgery based on their Staphylococcus (S.) aureus carrier state. The PubMed, Embase, Ovid, BioMed Central, Cochrane Central Register of Controlled Trials and Google Scholar databases were searched for studies comparing mupirocin‑based decolonization with controls for reducing SSIs in patients following CT surgery. Studies were grouped based on the targeted population of intervention, i.e. carriers or all patients. A total of 17 studies were included. Of these, 8 studies used targeted mupirocin‑based decolonization, while universal decolonization was performed in 9 studies. The results were conflicting for studies performing targeted decolonization and it was not possible to perform a meta‑analysis due to non‑homogenous studies. Pooled analysis of 34,859 patients indicated that universal mupirocin‑based decolonization significantly reduced the risk of all SSIs [risk ratio (RR): 0.54; 95% CI: 0.40,0.75; I2=73.35%]. The intervention significantly reduced the risk of superficial SSIs (RR: 0.37; 95% CI: 0.25,0.55; I2=0%) but not of deep SSIs (RR: 0.45; 95% CI: 0.19,1.09; I2=80.67%). The results indicated a significantly reduced risk of S. aureus SSIs (SA‑SSIs) with mupirocin‑based decolonization (RR: 0.44; 95% CI: 0.32,0.61; I2=0%) but not for methicillin‑resistant S. aureus (MRSA‑SSIs; RR: 0.25; 95% CI: 0.05,1.28; I2=79.07%). Evidence on the role of targeted mupirocin‑based decolonization to reduce SSIs after CT surgery was non‑coherent and inconclusive. Analysis of low‑quality retrospective studies suggested that universal mupirocin‑based decolonization may reduce all SSIs, superficial SSIs and SA‑SSIs, but not deep SSIs or MRSA‑SSIs in patients after CT surgery.
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May-2021
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Spandidos Publications style
Wang L, Ji Q and Hu X: Role of targeted and universal mupirocin‑based decolonization for preventing surgical‑site infections in patients undergoing cardiothoracic surgery: A systematic review and meta‑analysis. Exp Ther Med 21: 416, 2021
APA
Wang, L., Ji, Q., & Hu, X. (2021). Role of targeted and universal mupirocin‑based decolonization for preventing surgical‑site infections in patients undergoing cardiothoracic surgery: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 21, 416. https://doi.org/10.3892/etm.2021.9860
MLA
Wang, L., Ji, Q., Hu, X."Role of targeted and universal mupirocin‑based decolonization for preventing surgical‑site infections in patients undergoing cardiothoracic surgery: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 21.5 (2021): 416.
Chicago
Wang, L., Ji, Q., Hu, X."Role of targeted and universal mupirocin‑based decolonization for preventing surgical‑site infections in patients undergoing cardiothoracic surgery: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 21, no. 5 (2021): 416. https://doi.org/10.3892/etm.2021.9860