Impact of skin and nasal decontamination before cardiac surgery on postoperative Staphylococcus infection rate in children

Abstract Background Postoperative infections occur in about 10% of pediatric cardiac surgeries, involving Staphylococcus aureus in most of the cases. Nasal decontamination of Staphylococcus aureus with mupirocin has been reported to reduce postoperative Staphylococcus aureus infections after cardiac surgery in adults, but the effect of preoperative decontamination in children undergoing cardiac surgery has not been enough studied to determine a consensus. Aims We tried to evaluate the impact of systematic preoperative decolonization with intra nasal mupirocin application and chlorhexidine soap skin washing, on postoperative Staphylococcus infection in children undergoing cardiac surgery. Methods We conducted a monocentric retrospective study including children from 7days-old to 18 years-old undergoing cardiac surgery. Our population was divided in three groups according to decolonization protocol (group N: no decolonization, group T: targeted decolonization in Staphylococcus aureus carriers only, and group S: systematic decolonization). Results Three hundred and ninety three children were included between October 2011 and August 2015(122 in group N, 148 in group T and 123 in group S). Staphylococcus infection rate significantly decreased in group S compared to group N (0.8% vs. 7.7%; P  Conclusion Our study suggests that systematic preoperative skin and nasal decontamination decrease postoperative SI in children undergoing cardiac surgery.