266. Nasal Microbiome and the Effect of Nasal Decolonization with a Novel PovidoneIodine Antiseptic Solution: A Prospective and Randomized Clinical Trial
Abstract Background The presence of pathogenic bacteria in the anterior nares has gained substantial attention due to its association with an increased risk for surgical site infections. Nasal decolonization has been shown to reduce the risk for SSIs. Recent studies have suggested that the profile o...
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| Published in: | Open forum infectious diseases 2023-11, Vol.10 (Supplement_2) |
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| Main Authors: | , , , |
| Format: | Article |
| Language: | eng |
| Online Access: | Get full text |
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| Summary: | Abstract
Background
The presence of pathogenic bacteria in the anterior nares has gained substantial attention due to its association with an increased risk for surgical site infections. Nasal decolonization has been shown to reduce the risk for SSIs. Recent studies have suggested that the profile of the nose microbiome is a determining factor for the susceptibility to develop SSIs. Therefore, this prospective clinical trial was set up to study the profile of nasal microbiome and test the effect of a specific nasal decolonization solution on the microbiome.
Methods
We conducted a prospective study on 50 individuals who were randomly assigned to receive a nasal antiseptic solution (n=25) or a control PBS solution (n=25). The antiseptic solution (containing povidone-iodine [PVP-I] as the main ingredient) or PBS was administered with a cotton swab and a rotatory movement for 15 s in the anterior part of both nares. Nasal swabs were obtained before application (baseline) and at 3 different timepoints after application (5 min, 2 h, and 24 h). Nasal swabs were subjected next generation sequencing (NGS) analyses and cultured in trypticase soy agar plates.
Study design
Fifty volunteers were recruited for this randomized clinical trial. Block randomization was performed to determine group allocation, thus, PVP-I (n=25) or PBS (n=25) application in the anterior nares. We assessed bioburden at baseline, 5 minutes, 2 hours, and 24 hours post-application, meanwhile microbial diversity and mucociliary clearance was assessed at baseline and 24 hours post-application. Bacterial associations were assessed at baseline and non-desired events were examined at every follow-up visit.
Results
A high bioburden reduction was observed after the application of PVP-I (log10 3.538 ± 0.918 at 5 min; log10 2.961 ± 1.466 at 2 hours; and log10 0.849 ± 1.092 at 24 hours; p< 0.01), compared to PBS. At baseline, there were substantial associations between anaerobic species, Corynebacterium spp, Staphylococcus spp, and Dolosigranulum spp. The top species affected by the treatment were C. acnes, Staphylococcus, and Corynebacterium species, among others. None of the subjects in the study experienced any adverse effects associated with this study, nor increases in MCC time.
Bioburden reduction (A) and mucociliary clearance assessment (B)
A) Data is expressed as mean ± SEM CFU log10 reduction, from baseline bioburden. B) Sweetness detection, in minutes, at baseline and 24 hours post-application. |
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| ISSN: | 2328-8957 2328-8957 |