A low-tech approach that deters antibiotic-resistant bacteria from infesting hospital patients appears to prevent infection better than screening them for the troublesome microbes and isolating those patients, scientists report May 29 in the New England Journal of Medicine.
In many hospitals, current practice calls for screening patients as they are admitted to an intensive care unit by testing nasal swabs for methicillin-resistant Staphylococcus aureus, or MRSA, a common, dangerous infection. But this technique for catching the bug, treating it and preventing it from spreading within the hospital is far from foolproof.
An alternative method entails bathing patients who are headed for the ICU with antimicrobial soap and water, and dabbing their nasal cavities twice a day with antibiotic ointment. Researchers call this “decolonization” because it wipes out many microbes that colonize a patient’s skin or mucus-lined nasal passages.
In the study, researchers randomly assigned more than 74,000 ICU patients to get one of three treatments: decolonization; screening for MRSA; or screening and then decolonizing only patients who tested positive for MRSA. The group in which everyone received soap swabbing and nasal ointment developed fewer bloodstream infections than did either of the screening-based groups, reports physician Susan Huang of the University of California, Irvine, and colleagues.