***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective of this prospect i ve , r and omized , double-blind study was to evaluate the effect of the addition of mupirocin to the ‘ classical ’ topical SDD regimen ( tobramycin 80 mg , polymyxin E 100 mg , amphotericin B 500 mg ) on the development of ICU-acquired infections due to Gram-positive bacteria . The study was carried out in an intensive care unit ( ICU ) of a 1400-bed community hospital . All patients admitted to the ICU during a 16-month period , who were expected to require mechanical ventilation for more than 24 hours , were r and omized to receive either the ‘ classical ’ SDD regimen ( Group A ) or a modified regimen with mupirocin ( Group B ) . Data from 223 patients requiring mechanical ventilation for at least 48 hours , who were neither infected nor receiving antibiotics on ICU admission , was analysed . A 2 % paste containing tobramycin , polymyxin E and amphotericin B was applied every 6 hours in the oropharynx to the patients in Group A , while in Group B this formula was modified with the addition of 2 % mupirocin . In Group B 0.2 ml of a 2 % mupirocin ointment was also applied four times daily in both nostrils . Patients in Group A received a soft paraffin ointment as a placebo indistinguishable from mupirocin . Patients in both groups received the classic SDD regimen through the nasogastric tube . Systemic antibiotic prophylaxis was not used . Data on lower airway infection , and blood infection , infections of intravascular catheters , antibiotic consumption and expenditures for antibiotics were analysed . The diagnosis of ventilator-associated pneumonia ( VAP ) was based on quantitative cultures of protected specimen brush sample s ( PSB ) or on the results of distal broncho-alveolar lavage ( BAL ) . One hundred and four patients received the ‘ classical ’ SDD and 119 the modified regimen . Overall 29 patients , 20 in Group A and nine in Group B ( p < 0.02 ) had a total of 33 cases of pneumonia . There were 23 episodes of pneumonia in Group A and 10 in Group B ( p < 0.02 ) . Gram-positive bacteria were isolated from sample s in 17 episodes in Group A and six in Group B ( p < 0.02 ) . Staphylococcus aureus was isolated in nine cases of pneumonia in Group A and once in the ‘ mupirocin ’ group ( p < 0.05 ) . MRSA were isolated in seven out of nine cases in Group A and in the only case in Group B. There were no differences in the isolation of Gram-negative bacilli . Antibiotic consumption and cost were lower in Group B. In conclusion , our data show that the topical use of a modified formula of SDD , with the addition of mupirocin to the oral paste and in the anterior nares , is associated with a reduction in lung infections caused by gram-positives and in a reduction in antibiotic consumption and in the overall expenditure for antibiotics BACKGROUND Patients with severe burns are at increased risk of developing methicillin-resistant Staphylococcus aureus ( MRSA ) ventilator-associated pneumonia . This study was design ed to determine whether MRSA pneumonia can be prevented by prophylactic administration of trimethoprim-sulfamethoxazole ( TMP-SMX ) . METHODS We conducted a prospect i ve , r and omized , placebo-controlled study in patients with severe burns ( > or = 20 % ) , who required ventilator support . Prophylaxis was done with oral TMP-SMX ( 80 mg/400 mg ) three times daily for 10 days from 4 to 6 days after burn injury . The incidence of MRSA pneumonia and the side effects were evaluated during the administration period . RESULTS Twenty-one patients were assigned to receive TMP-SMX , and 19 patients to receive placebo .  The incidence of MRSA pneumonia was 4.8 % in the TMP-SMX group and 36.8 % in the placebo group , showing a significant difference ( p = 0.017 ) . No major side effects of therapy were seen in the TMP-SMX group . CONCLUSION Prophylactic treatment with TMP-SMX can prevent MRSA pneumonia in severely burned patients IMPORTANCE Infections due to Staphylococcus aureus are serious complications of cardiothoracic surgery . A novel vaccine c and i date ( V710 ) containing the highly conserved S. aureus iron surface determinant B is immunogenic and generally well tolerated in volunteers . OBJECTIVE To evaluate the efficacy and safety of preoperative vaccination in preventing serious postoperative S. aureus infection in patients undergoing cardiothoracic surgery . DESIGN , SETTING , AND PARTICIPANTS Double-blind , r and omized , event-driven trial conducted between December 2007 and August 2011 among 8031 patients aged 18 years or older who were scheduled for full median sternotomy within 14 to 60 days of vaccination at 165 sites in 26 countries . INTERVENTION Participants were r and omly assigned to receive a single 0.5-mL intramuscular injection of either V710 vaccine , 60 μg ( n = 4015 ) , or placebo ( n = 4016 ) . MAIN OUTCOME MEASURES The primary efficacy end point was prevention of S. aureus bacteremia and /or deep sternal wound infection ( including mediastinitis ) through postoperative day 90 . Secondary end points included all S. aureus surgical site and invasive infections through postoperative day 90 . Three interim analyses with futility assessment s were planned . RESULTS The independent data monitoring committee recommended termination of the study after the second interim analysis because of safety concerns and low efficacy . At the end of the study , the V710 vaccine was not significantly more efficacious than placebo in preventing either the primary end points ( 22/3528 V710 vaccine recipients [ 2.6 per 100 person-years ] vs 27/3517 placebo recipients [ 3.2 per 100 person-years ] ; relative risk , 0.81 ; 95 % CI , 0.44 - 1.48 ; P = .58 ) or secondary end points despite eliciting robust antibody responses . Compared with placebo , the V710 vaccine was associated with more adverse experiences during the first 14 days after vaccination ( 1219/3958 vaccine recipients [ 30.8 % ; 95 % CI , 29.4%-32.3 % ] and 866/3967 placebo recipients [ 21.8 % ; 95 % CI , 20.6%-23.1 % ] , including 797 [ 20.1 % ; 95 % CI , 18.9%-21.4 % ] and 378 [ 9.5 % ; 95 % CI , 8.6%-10.5 % ] with injection site reactions and 66 [ 1.7 % ; 95 % CI , 1.3%-2.1 % ] and 51 [ 1.3 % ; 95 % CI , 1.0%-1.7 % ] with serious adverse events , respectively ) and a significantly higher rate of multiorgan failure during the entire study ( 31 vs 17 events ; 0.9 [ 95 % CI , 0.6 - 1.2 ] vs 0.5 [ 95 % CI , 0.3 - 0.8 ] events per 100 person-years ; P = .04 ) . Although the overall incidence of vaccine-related serious adverse events ( 1 in each group ) and the all-cause mortality rate ( 201/3958 vs 177/3967 ; 5.7 [ 95 % CI , 4.9 - 6.5 ] vs 5.0 [ 95 % CI , 4.3 - 5.7 ] deaths per 100 person-years ; P = .20 ) were not statistically different between groups , the mortality rate in patients with staphylococcal infections was significantly higher among V710 vaccine than placebo recipients ( 15/73 vs 4/96 ; 23.0 [ 95 % CI , 12.9 - 37.9 ] vs 4.2 [ 95 % CI , 1.2 - 10.8 ] per 100 person-years ; difference , 18.8 [ 95 % CI , 8.0 - 34.1 ] per 100 person-years ) . CONCLUSIONS AND RELEVANCE Among patients undergoing cardiothoracic surgery with median sternotomy , the use of a vaccine against S. aureus compared with placebo did not reduce the rate of serious postoperative S. aureus infections and was associated with increased mortality among patients who developed S. aureus infections . These findings do not support the use of the V710 vaccine for patients undergoing surgical interventions . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00518687 Background Nosocomial Methicillin-resistant Staphylococcus aureus ( MRSA ) enteritis is rare but can be fatal unless it is detected at an early stage and treated effectively . Dysbiosis of the gut is one of the leading reasons of MRSA enteritis . Fecal microbiota transplantation ( FMT ) is a burgeoning treatment to rectify this imbalance . But the impact of FMT on MRSA enterocoitis is still unknown yet . Methods A total of 5 patients diagnosed as MRSA enteritis during the early postoperative period were given vancomycin 2 g/day for 3 days and FMT for three continuous days as a st and ard treatment . Result There was a 100 % clinical response rate that all the symptoms result ing from MRSA enterocolitis disappeared and MRSA in the feces eliminated clearly . The microbiota profile in feces of the patients also regained balance . Conclusion FMT can be a preferential measure to restore the dysbiosis caused by MSRA enterocolitis BACKGROUND Results of previous single-center , observational studies suggest that daily bathing of patients with chlorhexidine may prevent hospital-acquired bloodstream infections and the acquisition of multidrug-resistant organisms ( MDROs ) . METHODS We conducted a multicenter , cluster-r and omized , nonblinded crossover trial to evaluate the effect of daily bathing with chlorhexidine-impregnated washcloths on the acquisition of MDROs and the incidence of hospital-acquired bloodstream infections .  Nine intensive care and bone marrow transplantation units in six hospitals were r and omly assigned to bathe patients either with no-rinse 2 % chlorhexidine-impregnated washcloths or with nonantimicrobial washcloths for a 6-month period , exchanged for the alternate product during the subsequent 6 months . The incidence rates of acquisition of MDROs and the rates of hospital-acquired bloodstream infections were compared between the two periods by means of Poisson regression analysis . RESULTS A total of 7727 patients were enrolled during the study . The overall rate of MDRO acquisition was 5.10 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths ( P=0.03 ) , the equivalent of a 23 % lower rate with chlorhexidine bathing . The overall rate of hospital-acquired bloodstream infections was 4.78 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths ( P=0.007 ) , a 28 % lower rate with chlorhexidine-impregnated washcloths . No serious skin reactions were noted during either study period . CONCLUSIONS Daily bathing with chlorhexidine-impregnated washcloths significantly reduced the risks of acquisition of MDROs and development of hospital-acquired bloodstream infections . ( Funded by the Centers for Disease Control and Prevention and Sage Products ; Clinical Trials.gov number , NCT00502476 . ) BACKGROUND Nasal carriers of Staphylococcus aureus are at increased risk for health care-associated infections with this organism . Decolonization of nasal and extranasal sites on hospital admission may reduce this risk . METHODS In a r and omized , double-blind , placebo-controlled , multicenter trial , we assessed whether rapid identification of S. aureus nasal carriers by means of a real-time polymerase-chain-reaction ( PCR ) assay , followed by treatment with mupirocin nasal ointment and chlorhexidine soap , reduces the risk of hospital-associated S. aureus infection . RESULTS From October 2005 through June 2007 , a total of 6771 patients were screened on admission . A total of 1270 nasal swabs from 1251 patients were positive for S. aureus . We enrolled 917 of these patients in the intention-to-treat analysis , of whom 808 ( 88.1 % ) underwent a surgical procedure . All the S. aureus strains identified on PCR assay were susceptible 
    Output:
    
Mupirocin is effective in preventing S. aureus infections in patients receiving dialysis treatment and in surgical patients , particularly if the patients are carriers of S. aureus .
The combination of mupirocin and chlorhexidine , but not chlorhexidine alone , is also effective against S. aureus infections .
So far , vaccines have not proven successful in protecting against S. aureus infections .
Regarding prophylactic povidone-iodine and systemic antibiotics , there is limited evidence supporting their effectiveness against S. aureus infections .
Antimicrobial honey has not been proven to be more effective or non-inferior to mupirocin in protecting against S. aureus infections .
Conclusions The current evidence supports the use of mupirocin as prophylaxis for preventing infections with S. aureus , particularly in carriers and in the surgical setting or in patients receiving dialysis treatment .