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Evidence to Improve Care

Pre-surgical Nasal Decolonization of Staphylococcus aureus

Final Recommendation

  • Ontario Health, based on guidance from the Ontario Health Technology Advisory Committee, recommends publicly funding nasal decolonization with mupirocin combined with chlorhexidine body wash for adults before surgical procedures with a high risk of Staphylococcus aureus–related surgical site infection or where clinically indicated

Read the final recommendation report


Surgery carries a risk of infection as it involves cutting through the skin. The skin normally acts as a physical barrier to infectious pathogens such as bacteria and viruses. Surgical site infections increase the length of time people spend in hospital and, in severe cases, can increase the risk of death following surgery.

A type of bacteria called Staphylococcus aureus (S. aureus) is the most common cause of surgical site infections. Most types of S. aureus live in the human body, usually in the nose. A treatment called pre-surgical nasal decolonization may reduce the amount of bacteria present in people who are carriers of
S. aureus. It can be performed with or without topical antiseptic body wash in the days prior to a scheduled surgery. In this way, this treatment can prevent the bacteria from being transferred to the surgical site, thus reducing the risk of surgical site infection.

This health technology assessment looked at how safe, effective, and cost-effective nasal decolonization of S. aureus with or without topical antiseptic body wash is for people undergoing surgery. It also looked at the budget impact of publicly funding nasal decolonization, with or without topical antiseptic body wash. And it considered the experiences, preferences, and values of people undergoing surgery.

Read the full health technology assessment report for more information.

Pre-surgical Nasal Decolonization of Staphylococcus aureus: A Health Technology Assessment
August 2022

  • PDF

  • XML (accessible version)

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The Ministry of Health is currently reviewing this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review health technology assessments and funding recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.



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