Decolonization Guidelines

Increasingly, society and organization guidelines recommend including decolonization protocols to help lower the risk of hospital onset Staphylococcus aureus infections. Nasal and body staphylococcal decolonization include high risk patients including surgical and ICU patients, and among those with certain indwelling devices.

Organization Recommendations for Prevention of Healthcare-Onset S. aureus Infections

Centers for Disease Control and Prevention (CDC)

Surgical patients: For all patients undergoing high risk surgeries (e.g. cardiothoracic, orthopedic, and neurosurgery), unless known to be S. aureus negative, use an intranasal anti-staphylococcal antibiotic/antiseptic and CHG wash or wipes prior to surgery (core strategy).

ICU patients: Decolonize all patients with intranasal staphylococcal antibiotic/antiseptic plus topical CHG (core strategy).

Non-ICU patients: Decolonize patients with CVC or midline catheter with intranasal staphylococcal antibiotic/antiseptic plus topical CHG (supplemental strategy).

View CDC recommendations

Health Research and Educational Trust (HRET)

Surgical patients: Integrate CHG bathing and intranasal decolonization with mupirocin, povidone iodine nasal antiseptic, or alcohol-based nasal therapy into the decolonization protocol.

View HRET recommendations

Society for Healthcare Epidemiology of America (SHEA)

ICU: MRSA decolonization can be targeted to MRSA-colonized persons or applied universally to populations deemed to be at high risk for infection. (Level 1 Evidence: Provide universal decolonization to ICU patients when MRSA not effectively controlled).

View SHEA recommendations

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Guidelines for Staphylococcal Decolonization

Recommendations from CDC, SHEA and HRET

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