Over two years 50 MRSA patients in 6 hospitals were observed. Treatment was defined zinc and allergies the daily application of Stellisept scrub for the antiseptic body and hair wash at least 60 s in combination with nasal mupirocin.
A treatment cycle was mrsa antibacterial soap minimum of 5 days treatment. Screening was carried out at least 48 h after the treatment cycle was finished, with 24 h between each of the requested three or more samplings, mrsa antibacterial soap included the nasopharynx, groin, axilla, perineum and other MRSA-positive skin areas. Fifteen cases were retrospectively excluded lack of outcome documentation, concomitant antibiotic therapy, open wounds.
Colonization at more than one skin sites was found in After one treatment cycle MRSA was eradicated in 25 patients No patient discontinued the antiseptic treatment due to dermal intolerance of the product. Progressive eradication of MRSA carriage was observed with mrsa antibacterial soap antiseptic soap and mupirocin, mrsa antibacterial soap.
The eradication rate was not biased by concomitant antibiotic treatment, screening during treatment or lack of evidence for colonization in contrast to other studies with other preparations, mrsa antibacterial soap. Methicillin-resistant Staphylococcus aureus MRSA continues to be a global problem in infection control.
For many years it has been a major cause for nosocomial infections in many countries [ 12 ]. The proportion of methicillin resistance among clinical isolates of S. MRSA now even becomes an increasing problem in the community [ 56 ]. Dermal colonization with MRSA may be persistent, mrsa antibacterial soap, especially in the groin [ 8 ].
That is why attempts are often undertaken to treat mrsa antibacterial soap MRSA patients [ 9 ]. But antibiotics are considered to be inappropriate for patients who are only colonized and not infected with MRSA [ 13 ].
One reason is their potential to cause adverse effects, especially allergy, which can not be justified for patients who do not have an infection. More important is the risk of emergence of vancomycin-resistance in S. Topical antiseptic measures, however, are normally employed [ 15 ], mrsa antibacterial soap. The nasal cavity is usually treated with mupirocin or with tolerable antiseptics [ 16 ].
Dermal colonization is eradicated with antiseptic liquid soaps [ 13 ] Only few studies have addressed the question of MRSA eradication among colonized patients with liquid soaps in combination with nasal treatment. All of them are uncontrolled trials and most of them have different types of biases. Aim of our study was to determine the efficacy of the antiseptic soap Stellisept scrub in combination with mupirocin for eradication of MRSA among colonized patients with evidence of dermal colonization no selection biaswithout concomitant antibiotic therapy no treatment bias and with regular screening investigations no outcome bias.
The MRSA carrier status was determined before and after treatment of the patients. Swabs were taken at least from the following body sites: Any patient with at least one MRSA positive skin site was regarded as a patient with evidence for dermal colonization irrespective of the nasal colonization status.
All swabs were processed on the same day. Briefly, swabs were plated directly on blood agar, oxacillin resistance screening agar base Oxoid, UKand dextrose broth for enrichment. This was done in two steps: Isolates growing within 14 mm around the oxacillin disk and growing on the MRSA screening plates were regarded as oxacillin resistant. Definition of treatment and treatment cycle: A treatment cycle was defined as a minimum of 5 days treatment.
The minimum duration of antiseptic skin treatment was 60 s. This application time is derived from in vitro data on the activity of the product against various epidemic MRSA strains and various clinical MRSA isolates [ 17 ]. For body washing the skin was moistened with tap water and the liquid soap applied without dilution. Mobile patients washed themselves under supervision of a mrsa antibacterial soap worker.
Immobile patients were washed by healthcare workers. After the 60 s application residual soap had to be rinsed or washed off with tap water.
Linen and clothes were changed during the antiseptic treatment and the surrounding surfaces treated with a surface disinfectant [ 13 ], mrsa antibacterial soap. Six hospitals participated in the study, mrsa antibacterial soap.
The local infection control nurse of a hospital was responsible for data collection. The following data were collected for each patient: The microbiological method in each hospital for identification of MRSA from initial and follow-up swabs was not evaluated for its sensitivity and specificity since it has become routine in German laboratories.
A minimum wash-out period of 48 h was required between the last treatment and the first set of screening swabs. Screening swabs had to be taken for three consecutive days and at least from the following sampling sites: Additional body sites were included if they were found to be MRSA positive before antiseptic treatment.
Four of the 50 patients were discharged early resulting in a lack of information on the outcome colonization with MRSA after antiseptic mrsa antibacterial soap. Eight patients received concomitant systemic antibiotic therapy initiated mrsa antibacterial soap inclusion in the study. Three patients had a colonized or infected wound which was treated during the study. All of them were excluded resulting in a total of 35 cases with proven dermal MRSA colonization and without concomitant systemic antibiotic therapy.
Multiple colonization of the skin was found in Frequency of MRSA detection at different body sites among 35 patients undergoing antiseptic body wash and nasal antiseptic therapy for eradication of MRSA; colonization of multiple anti allergy filter for air conditioners sites possible.
After one cycle of antiseptic body wash and concomitant nasal antisepsis with mupirocin, 25 of the 35 patients were found to be MRSA free The mean duration of treatment was 6.
Treatment failures after the first cycle were due to persistent colonization of the same skin area 5 of 10colonization of another skin area 4 of 10 and persistent colonization of the nasopharynx 1 of Of the remaining 10 patients, two were not treated any further due to discharge and 8 underwent a second treatment cycle with seven of them being MRSA negative afterwards total of The mean duration of treatment in the second cycle was 6.
In order to confirm successful eradication of MRSA after the second cycle, mrsa antibacterial soap, three consecutive series of swabs were negative mrsa antibacterial soap six patients The one patient remained colonized on the same skin area without nasal carriage and underwent a third treatment cycle resulting in dermal MRSA eradication total of Three series of consecutive swabs were negative to confirm successful eradication of MRSA.
Mrsa antibacterial soap patient had to discontinue the antiseptic body wash due to dermal intolerance or uncomfortable perception of the product.
Although eradication of MRSA from colonized patients is regarded as a key element in prevention of transmission in a hospital, so far only few studies have addressed the clinical efficacy mrsa antibacterial soap antiseptic soaps in combination with a nasal antiseptic for that purpose. In addition, most of the uncontrolled trials contain substantial biases which limit or even diminish the value of them. Summary of clinical trials on eradication of MRSA including the colonization status before treatment, the main outcome and type of bias.
In our study, mrsa antibacterial soap, we found an eradication rate after one treatment cycle of After two treatment cycles, the rate was With no other antiseptic soap we were able to find comparable data which are not confounded by a lack of evidence for initial MRSA colonization, concomitant antibiotic therapy or screening cultures during antiseptic treatment. One limitation of our study is the lack of a control. We can not exclude that washing with plain soap and water or doing nothing would not have had a similar effect regarding the eradication of MRSA, although it is very unlikely based the persistence of MRSA colonization in the groin [ 8 ].
It would have been much more interesting to compare Stellisept scrub with either a non-medicated soap negative control or another antiseptic soap e, mrsa antibacterial soap.
But the use of non-medicated liquid soap would have been acting against the German recommendation for MRSA patients antiseptic soaps or liquid preparations should be used for treatment of the skin [ 13 ], mrsa antibacterial soap. The use of medicated soap, mrsa antibacterial soap, however, would have been an interesting option, ideally in a double-blind randomized design.
But chlorhexidine as the most common active agent for this type of treatment has been described in recent studies with artificial contamination of fingers with MRSA to have no advantage compared with non-medicated liquid soap [ 1920 ]. It was therefore not considered to be suitable as a positive control [ 21 ]. That is why an open uncontrolled design was chosen. Another limitation is the rather short follow-up of 5 days after termination of the treatment 2 days wash-out and 3 days screening cultures.
Most patients stayed as long in their hospital as it was necessary to complete the screening cultures. The main reason for even shorter follow-up is discharge of the patient from a hospital. Continuation of hospital stay with the only aim to complete screening cultures was not possible in our study.
Follow-up was unknown in some studies [ 2223 ], mrsa antibacterial soap, shorter mrsa antibacterial soap others [ 24 ] or longer [ 1018 ], but in some studies not for all patients [ 825 ]. Treatment failures after the first cycle were mainly observed at the same or another skin site, mrsa antibacterial soap. The surrounding may also contribute to re-colonization of a patient.
It was shown in one of our cases to originate from an electric shaver which was not disinfected at all. MRSA may survive on inanimate surfaces and cotton for more than 90 days [ 26 ]. Snps and cancer making the bed leads to a large increase of MRSA in the air for 15 minutes [ 27 ].
Careful disinfection of these possible sources and mrsa antibacterial soap linen after weight loss and dr oz antiseptic treatment is therefore crucial to ensure prevention of re-colonization as recommended in the German guideline on MRSA patients [ 13 ], mrsa antibacterial soap.
Identification of MRSA was not carried out for all screening swabs in one laboratory but with the same test method, mrsa antibacterial soap. Differences in the sensitivity and specificity have been described [ 28 - 30 ] which may thyroid cancer and treatment an impact on the identification of a MRSA patient. But it is unlikely to have an impact on the result of the antiseptic treatment because the method would have been the same before and after treatment of the wireless air cards and data plans patient.
Wheat allergy and fiber is why it was justified not to carry out the identification of MRSA in one specific laboratory especially because recent data indicate that determination of phenotypic resistance may largely underestimate the genotypic resistance in MRSA [ 31 ]. Another finding is the good dermal tolerance of the antiseptic soap. All 35 patients tolerated repetitive use of the preparation very well, even more than one treatment cycle.
Another preparation Octenisept has been described to lead to skin redness in 4 of 28 patients resulting in termination of the treatment [ 25 ].
The excellent dermal tolerance of Stellisept scrub on intact and scarified skin has been described before [ 32 ]. Stellisept scrub in combination with nasal mupirocin was found to effectively and progressively eradicate MRSA from colonized patients. Antiseptic treatment may vitamin c and heart disease to be repeated. GK designed the study, organized the participating hospitals, collected the data and analyzed them.
AK participated in the design of the study and in the analysis of data, mrsa antibacterial soap.