There are a number of studies that have demonstrated conclusively that eliminating a large percentage of the bacteria in the nose of a patient just prior to a major surgery can reduce the number of surgical site infections (SSIs).Â Â The main culprit seems to be Staphylococcus aureus which thrives in the warm, moist undisturbed environment in the nose. Whether it is the highly antibiotic resistant form of S. aureus, MRSA (a known superbug) or the antibiotic susceptible version MSSA, these species of bacteria are responsible for the majority of surgical site infections.
While MSSA is responsible for a greater number of SSIs, MRSA is responsible for the deadly and very costly infections. Some MRSA infections can cost up to $100,000. On average however, SSIs cost anywhere between $11,000 – $35,000, add on average an extra 8 hospital days, and can result in 5 times higher readmission rates. Whichever way one looks at it, SSIs are a huge burden on the medical systems around the world. Some estimates put this cost as much as $10 billion annually in the US alone.
Because of the cost and the mortality rates, many high risk patients in North America are screened for carriage of MRSA prior to surgeries. In the UK, all patients are screened prior to surgery. Patients found to be carriers of MRSA may be deprived of surgery, isolated or pretreated with antibiotics in an effort to reduce the occurrence of SSIs, as well as reduce the spread of MRSA to medical workers or other patients. Patients, especially in the case of the elderly or the immune-compromised (diabetics and cancer patients), may be deprived of surgery if they are carriers of MRSA as the risk of self infection is seen to offset the advantages of surgery.Â Patients identified as carriers need to be tested up to 5 days in advance of surgeries as this is the length of time needed by antibiotics to eliminate/reduce the bacteria. The disadvantages of using topical antibiotics to prevent SSIs include resistant formation, lack of patient compliance, and the time prior to surgery needed to allow for efficacy.
Nasal decolonization has been proven to reduce the incidence of surgical site infections. An instant, non-antibiotic therapy that is easy to use just prior to surgery would have great value to the medical system. Photodisinfection offers these advantages and is a simple solution to complex bacterial infections.
- Scott RD, CDC. The Direct Medical Costs of Healthcare-Associated Infection In Us Hospitals and the Benefits of Prevention, March 2009.
- Thompson KM et al. Chasing Zero: The Drive To Eliminate Surgical Site Infections. Ann Surg 2011 Sep: 254(3):430-6