Industry Roundtable: Nasal Decolonization

Categories: Articles & Healthcare June 11, 2018

PDI Healthcare’s Joan Hebden MS, RN, CIC, Fapic, President, IPC Consulting Group, LLC, was featured in an Industry Roundtable for Infection Control Today on nasal decolonization.


Industry Roundtable: Nasal Decolonization

Infection Control Today (infectioncontroltoday.com)

Author: Infection Control Today with Expert Commentary from Joan Hebden MS, RN, CIC, Fapic, President, IPC Consulting Group, LLC.

Excerpt:

Decolonization is an evidence-based practice to reduce the incidence of healthcare-associated infections. Nasal decolonization, with or without chlorhexidine gluconate bathing, has become an important strategy for reducing surgical site infections (SSIs) due to S. aureus – the primary pathogen responsible for these infections — and for the control of methicillin-resistant Staphylococcus aureus (MRSA) transmission in healthcare settings with endemic prevalence. The gold standard for nasal decolonization has been mupirocin; however, as seen with widespread use of other antibiotics, selective pressure has led to mupirocin-resistant strains of S. aureus and treatment failures. As part of an overall approach to antibiotic stewardship, investigators have looked to antiseptics as alternatives for nasal decolonization. Povidone-iodine (PVP-I) has more rapid bactericidal activity against S. aureus compared with that of mupirocin and has activity against emerging mupirocin-resistant MRSA strains. The use of PVP-I for nasal decolonization in combination with chlorhexidine bathing has revealed statistically significant reductions in SSIs among patients undergoing orthopedic and spinal surgeries and a 40 percent reduction in MRSA nasal carriage and a 60 percent reduction in any MRSA carriage among nursing home residents. Greater patient satisfaction with PVP-I vs. mupirocin has been reported. 3.4 percent of patients receiving PVP-I reported an unpleasant or very unpleasant experience compared with 38.8 percent of those using mupirocin (P<.0001). There have been no reports of bacterial resistance or increased tolerance associated with PVP-I.

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