Microbiological Contamination of Nasal Topical Preparations Used After Septoplasty: A Comparative Analysis

The aim of this study was to evaluate the microbiological contamination rates of nasal topical preparations (sprays, drops, and ointments) used after septoplasty at the nozzle/tube tip and drug content levels. The study also aimed to compare contamination levels in different formulations.

This prospective cross-sectional study included 110 patients (spray: n=38; drop: n=34; ointment: n=38) who underwent septoplasty at the ENT clinic. Patients returned their preparations after at least two weeks' postoperative use. Two separate samples were obtained from each preparation: a swab of the nozzle or tube tip and the drug content. These specimens were inoculated onto blood agar, chocolate agar, and Sabouraud dextrose agar. Isolate identification was performed using the VITEK MS (MALDI-TOF MS) system.

Nozzle contamination was detected in 62.7% (n=69) of the 110 preparations, and content contamination was detected in 40.9% (n=45). Nozzle contamination was significantly higher in the spray group (89.5%) than in the drop (44.1%) and ointment (52.6%) groups (p<0.001). The most frequently isolated microorganisms were coagulase-negative staphylococci (particularly Staphylococcus epidermidis) and Staphylococcus aureus. Gram-negative bacteria (e.g., Klebsiella spp. and Pseudomonas aeruginosa) and yeast species (e.g., Candida parapsilosis and Candida haemulonii) were detected less frequently.

Spray formulations showed higher nozzle contamination rates than other formulations, whereas drug-content contamination appeared similar across groups. These findings suggest that contamination may occur in topical nasal preparations used after septoplasty and highlight the importance of patient education regarding hygienic use during the postoperative period. However, because baseline sterility testing and laboratory negative controls were not performed, the source of contamination cannot be determined conclusively.