Decolonization, also bacterial decolonization, is a medical intervention that attempts to rid a patient of an antimicrobial resistant pathogen,such as methicillin-resistant Staphylococcus aureus (MRSA) or antifungal-resistant Candida.
By pre-emptively treating patients colonized with an antimicrobial resistant organism, it lowers the likelihood of the patient going on to develop life-threatening health care-associated infections.
The REDUCE MRSA Randomized Evaluation of Decolonization vs. Universal Clearance to Eliminate methicillin-resistant Staphylococcus aureus (MRSA)), determined decolonization with chlorhexidine and mupirocin of all patients without screening was the most effective method of reducing the presence of MRSA and overall number of bloodstream infections.
Decolonization is used to reduce rates of infections caused by MRSA. Staphylococcus aureus (S. aureus) is a common cause of hospital related infections, including blood stream infections and infections of the heart and bone.
Decolonization protocols have been implemented in many hospital networks to decrease MRSA infections.
Decolonization decreases or minimizes patient bacterial load.
Targeted decolonization involves screening patients for MRSA then iimplementing decolonization protocols for patients who test positive for MRSA.
Universal decolonization involves no screening and decolonization for all patients in a given hospital setting or department.
Decolonization typically uses chlorhexidine rinses for bathing or showering, a mouthwash to clean the oral cavity, and a nasal spray containing mupirocin.
It is important to include a mouthwash and nasal spray as individuals commonly carry MRSA in the nose, mouth, and throat.
Chlorhexidine is used disinfect skin prior to surgery, surgical instrument sterilization, and in hand disinfectants in healthcare settings.
Chlorhexidine in the mouthwash form, it is commonly used for gingivitis.
Mupirocin , a topical antibiotic commonly used for superficial skin infections and has been approved by the FDA nasal decolonization.
Alternative antibiotics and antiseptics, like povidone-iodine, are used in decolonization.
Chlorhexidine shampoo or body wash is used daily and mupirocin nasal spray twice daily.
It is recommended to use of these products for five days twice a month over a sixth month period.
The Muciprocin-Iodophor Swap Out trial provided evidence to prevent Staph aureus infections, including MRSA by nasal decolonization effectively reducing staphylococcal infections in nursing home patients.
Decolonization is a relatively safe medical intervention.
Local skin irritation is the most common side effect.