MRSA prevalence rates detected in a tertiary care hospital in Austria and successful treatment of MRSA positive patients applying a decontamination regime with octenidine

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) decontamination regimens predominantly use chlorhexidine bathing in combination with mupirocin nasal ointment. However, resistances in Staphylococcus aureus strains are increasingly common and there is a need of alternative, safe and feasible protocols. This interventional cohort study performed at the Albert Schweitzer Hospital in Graz, Austria, aimed to (1) determine MRSA prevalence at different body sites and (2) assess the efficacy of the decontamination using octenidine-based leave-on products added to existing robust infection control measures. All inpatients of this tertiary care hospital being treated in geriatric medical wards (GWs) and apallic care units (ACUs) were screened for MRSA and decontamination rates were determined after one, two or three decontamination cycles, respectively. At baseline, MRSA was detected in 25 of the 126 patients screened (19.8%). We found MRSA in 13/126 (10.3%) swabs from nasal vestibules, in 12/126 (9.5%) skin swabs, in 11/51 (21.6%) swabs from PEG-stomata or suprapubic catheters and in 8/13 (61.5%) tracheostomata swabs. A maximum of three 5-day decontamination cycles reduced the number of MRSA positive patients by 68.0%. Excluding non-compliant and deceased patients, decontamination reduced MRSA carriage by 93.3% (n = 15). No adverse events related to the applied decontamination regimen occurred. Exclusive screening of the nose might underreport MRSA prevalence rates. In this study, decontamination with octenidine-based leave-on products was safe and effective in a critical patient population.

The Antiseptic Octenidine Inhibits Langerhans Cell Activation and Modulates Cytokine Expression upon Superficial Wounding with Tape Stripping

“…In addition, it is the only antiseptic which remains active locally for up to 48 hours and is not associated with systemic side effects [26, 27]. OCT is widely used in Europe for skin, mucous membrane, and wound antisepsis [25, 28] as well as for patient decolonization in various clinical settings [29–31], and resistances have not been reported [32]. Even though very few cases of irritant and/or allergic contact dermatitis have been reported when superficial skin infections were treated with OCT [33, 34], it is generally considered to be a safe and efficient antiseptic [25].…”

Protecting patients from infection: Improving topical prophylaxis compliance on surgical wards

“…A recent study by Reiser et al (2017) suggested that Octenidine body wash did not reduce the rate of SSI for patients undergoing coronary artery bypass grafts, but did significantly decrease the harvest site and organ/space sternal SSIs. For MRSA colonisations, Pichler et al (2018) concluded that application of Octenidine body wash reduced MRSA colonisations by 93%, although this study was undertaken on medical rather than surgical wards. Similarly Chow et al (2018) found that Octenidine body wash reduced MRSA prevalence rates by 58% in an extended care facility.…”

Bullous skin lesion reaction as an example of an adverse effect of a preparation containing 0.1% octenidine dihydrochloride and 2% phenoxyethanol (Octenisept®)

“…Rekomendowany jest do stosowania na powierzchnię skóry, błon śluzowych i ran [1]. Działanie przeciwbakteryjne przejawia w stosunku do bakterii Gram-ujemnych i Gram-dodatnich, w tym bakterii atypowych oraz gronkowca złocistego opornego na metycylinę (methicillin-resistant Staphylococcus aureus -MRSA) [1][2][3][4]. Wykazano także, że preparat inaktywuje wirusy otoczkowe, których przedstawicielami są m.in.…”

“…It is recommended to be applied on skin, mucous membranes and wounds [1]. Antibacterial activity of this antiseptic encompasses Gram-positive and Gram-negative bacteria, including atypical bacteria and methicillin-resistant Staphylococcus aureus (MRSA) [1][2][3][4]. Moreover, it has been proved that Octenisept ® inactivates enveloped viruses, that are represented inter alia by herpes simplex virus and hepatitis B virus [5] and has protozoicidal properties against Trichomonas vaginalis [6].…”