Evaluation of an alcohol-based antiseptic for nasal decolonization of methicillin-resistant Staphylococcus aureus in colonized patients

Steed et al4 reported that an alcohol-based nasal antiseptic reduced the burden of S. aureus in the nares of healthcare personnel. [...]in a quasi-experimental study, perioperative use of an alcohol-based nasal antiseptic by orthopedic patients and personnel was associated with reduced infection rat...

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Bibliographic Details
Published in:Infection control and hospital epidemiology 2019-12, Vol.40 (12), p.1436-1437
Main Authors: Kanwar, Anubhav, Kumar, Jessica A, Ng-Wong, Yilen K, Thakur, Manish, Cadnum, Jennifer L, Alhmidi, Heba, Mana, Thriveen S C, Jencson, Annette L, Donskey, Curtis J
Format: Article
Language:English
Subjects:
Alcohol
Alcohols
Decolonization
Flora
Health care
Lavage
Medical personnel
Nose
Nursing
Otolaryngology
Sanitizers
Staphylococcus infections
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Summary:Steed et al4 reported that an alcohol-based nasal antiseptic reduced the burden of S. aureus in the nares of healthcare personnel. [...]in a quasi-experimental study, perioperative use of an alcohol-based nasal antiseptic by orthopedic patients and personnel was associated with reduced infection rates.5 These findings are promising, but more information is needed regarding the efficacy of alcohol-based sanitizers in reducing nasal S. aureus in colonized patients. [...]organic material reduces the efficacy of alcohol and may be present in relatively large amounts in the nares.7,8 Third, S. aureus in the nares may not be accessible to alcohol treatment (ie, embedded within mucus and at the base of hair follicles).9 At such sites, S. aureus in the nares may be analogous to resident skin flora on hands that is minimally suppressed by alcohol.7 Finally, alcohol has only a transient antibacterial effect, and more persistent activity may be required to reduce the burden of nasal MRSA.7 Our results differ from a recent report of significant reductions in the burden of nasal S. aureus in healthcare personnel with the alcohol-based nasal antiseptic applied 3 times during an 8-hour period.4 The differing results may be related in part to differences between colonized patients and personnel. For the assessment of repeated applications, no control group was included, and the number of participants was low. Because the triple-dose alcohol application significantly reduced MRSA for at least 2 hours, it is possible that frequent, relatively high doses of alcohol might maintain S. aureus suppression.
ISSN:0899-823X
1559-6834
DOI:10.1017/ice.2019.266