Microbiological effect of mupirocin and chlorhexidine for Staphylococcus aureus decolonization in community and nursing home based adults

•Adults with S. aureus were compared by residence before and after decolonization.•Decolonization decreased S. aureus colonization in both populations for 4-8 weeks.•Decolonization did not increase Gram-negative rod colonization in either population.

ObjectiveTo compare the presence of Staphylococcus aureus and pathogenic Gram-negative rods (GNR) in the anterior nares, posterior pharynx and three skin sites in community-based adults and nursing home-based adults before and after treatment with nasal mupirocin and topical chlorhexidine.MethodsS. aureus-colonized adults were recruited from the community (n = 26) and from nursing homes (n = 8). Eligible participants were cultured for S. aureus and GNR during two study visits and then received intranasal mupirocin and topical chlorhexidine for 5 days, with a 2-month follow-up period.ResultsAfter decolonization, we found sustained decreases of S. aureus colonization in nose, throat and skin sites over 4-8 weeks in both populations. Intranasal mupirocin did not increase GNR colonization in nose or throat. Chlorhexidine did not decrease GNR colonization in skin sites.ConclusionsDecolonization with mupirocin and chlorhexidine leads to a sustained effect on S. aureus colonization without affecting GNR colonization.