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Research finds potential low-cost intervention to lower infection rates
Helen Adams | MUSC News Center | July 30, 2014
|Scanning electromicrograph of the interaction of MRSA (blue bacteria) with a human white cell. The bacteria shown is strain MRSA252, a leading cause of hospital-associated infections in the United States and United Kingdom.|
A new study using MUSC employees as subjects strengthens MUSC’s cause in the fight to lower health care-associated infections with findings that suggest use of a nasal sanitizer may protect patients from staph germs.
Staph, also known as Staphylococcus aureus, can cause conditions ranging from boils to pneumonia.
“We were open-minded and wanted to come up with a hypothesis to determine whether or not a low-cost intervention could reduce staph carriage. It was neat that it worked,” said Shaun Nguyen, M.D., the principal investigator for the study and MUSC’s director of clinical research in the Department of Otolaryngology.
The hypothesis was that a low-cost intervention, in this case the nasal sanitizer Nozin Nasal Sanitizer Antiseptic, could keep health care professionals who tested positive for staph in their noses, where staph likes to hide, from passing along the germs to patients.
It is possible to have staph germs in the nose without feeling any effects. Problems arise when it is passed along to someone else who has a cut, bug bite or other skin condition that can allow the staph to cause an uncomfortable infection.
Nguyen said the group of nurses and technicians his team selected was a perfect fit because the employees come into regular contact with patients but are not normally screened for staph.
The researchers sought volunteers for the study, then screened them for staph in their noses. They found that about 20 percent of the employees tested were carrying staph, which is the same prevalence found in the general population. Next, they assigned employees who tested positive for staph to either be swabbed with Nozin or treated with a placebo as part of a control group.
The researchers reapplied the treatments during a 10-hour work day. At the end of that time, they checked to see if the nasal sanitizer had temporarily reduced the amount of staph in the employees’ noses. In most cases, it had. That means patients who came into contact with the employees who used Nozin were unlikely to catch staph from them.
The test involved about 40 employees. Of the people who were treated with the nasal sanitizer, all but one showed a reduction in the amount of staph in their noses. The reduction in staph was even more dramatic in some cases: Half of the Nozin subjects had a 100 percent decrease, according to results from the study published in the American Journal of Infection Control May 19.
Nguyen and his team, including co-principal investigator Lisa Steed, Ph.D., a microbiologist and Cassandra Salgado, M.D., hospital epidemiologist, plan to conduct a larger study on a similar population for a longer period to see the lasting effect of Nozin.
Since Nozin is an alcohol-based antiseptic and does not include antibiotics, it is both relatively inexpensive and unlikely to contribute to the growth of antibiotic-resistant bacteria, a big concern among doctors.
Nozin is already available over the counter, but it can be difficult to find in stores. The company’s website lists it for sale at about $15 for a box of 10 doses.
Nguyen and Steed said that while Nozin appears to be helpful in a hospital setting, it may find its true niche in other places that involve long-term stays.
“I think the main benefits will be in nursing homes and places where patients are in there for a long period of time,” Nguyen said. “Rehab facilities, nursing homes – places like that. This is a low-cost intervention that potentially can impact patients’ health in a significant way.”
The study was conducted in collaboration with Ernst Spannhake of the Johns Hopkins School of Public Health. The grant was secured by Nguyen and Steed.
The research adds to MUSC’s ongoing efforts to prevent health care-associated infections, including a previous study that found copper could play a valuable role in reducing them.