Laser-assisted nasal decolonization of Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus

Area of Science:

• Infectious Diseases
• Medical Technology
• Antimicrobial Resistance

Background:

• Staphylococcus aureus, including MRSA and MSSA, causes significant nosocomial infections, leading to increased complications, healthcare costs, and antibiotic resistance.
• Nasal decolonization (ND) is a strategy to reduce the incidence of staphylococcal infections.
• Novel methods for effective ND are crucial for infection control.

Purpose of the Study:

• To evaluate a new method of laser therapy (LT) for methicillin-resistant Staphylococcus aureus (MRSA) nasal decolonization (ND).
• To assess the efficacy of different laser therapy protocols, alone or in combination with topical antimicrobial agents, for MSSA/MRSA nasal clearance.

Main Methods:

• A prospective, nonrandomized study involving 25 patients colonized with MSSA/MRSA.
• Patients were allocated to four treatment arms: low-power dual-wavelength laser alone, laser with erythromycin cream, laser with peroxide irrigation, and high-power laser alone.
• Quantitative nasal cultures were performed pre- and post-treatment. Laser therapy involved delivering 200-600 J/cm² to each naris.

Main Results:

• The combination of laser therapy and erythromycin cream (LT + E-mycin) demonstrated high efficacy, clearing MSSA/MRSA in 13 out of 14 patients.
• Overall, over 90% of patients achieved nasal decolonization with the LT + E-mycin regimen.
• No adverse events or patient discomfort were reported during the study.

Conclusions:

• This study presents the first human trial of laser therapy combined with topical erythromycin for nasal decolonization.
• Laser therapy, particularly when combined with erythromycin, can effectively eradicate MRSA and MSSA nasal carriage.
• The findings suggest LT may resensitize bacteria to erythromycin, and decolonization was maintained at 4 weeks, warranting further investigation into long-term effects.