Is it clear that decolonization effectively prevents infection?
There have been a lot of negative prospective trials looking at nasal decolonization for patients with MRSA. [But] if you look at the places where the interventional trials have been done, it’s always in patients in much lower-risk groups. One paper came out in the New England Journal of Medicine in January attempting nasal decolonizations in surgical patients preoperatively. They showed a reduction in surgical- site infections. Q: Between that trial and your research, is there sufficient evidence that hospitals should start decolonizing ICU patients? A: I don’t think it’s proven. [Our] trial’s not an interventional trial. I still think a large, randomized, placebo-controlled trial needs to be done. But because we now have some positive data in lower-risk populations, I think it makes sense to start doing it in the highest-risk population. Q: How would you identify the patients to test for colonization? A: Any patients you are seeing in the emergency room or on the floors who are sick
