Can a nasal and skin decolonization protocol safely replace contact precautions for colonized MRSA patients?

Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities

“…The studies used a skin decolonisation regimen with 1% triclosan, 138,151 5% tea tree oil, 152 polyhexanide cloths, 153 3% hexachlorophene 139 as well as the nasal application of 30% medical grade honey ointment, 138 polyhexanide gel, 152 polysporin triple ointment, 93 ofloxacin drops for eradication of MRSA in the ears, 136 gentamicin cream for peritoneal catheter exit sites 140 and alcohol-based nasal antiseptic. 154 One of these studies, 154 a UBA, suggested a potential benefit when using selective alcohol-based nasal antiseptic administered twice daily in addition to CHG bathing in place of extensively used contact precautions (CP) for all MRSA colonised patients. The authors reported that the incidence of MRSA BSI remained the same (data not reported) while they successfully reduced the number of isolation days by 88.33% (p<0.0001) as well as a reduction in glove and gown use, which provided a saving of USD 430,604 (approx.…”

“…Additional evidence was obtained from national guidelines 197 and seven UBA studies 154,[209][210][211][212][213][214] which attempted to discontinue CP in hospitals (including ICU and general wards). In one of these studies a nurse cohorting area was associated with a significant decrease in MRSA transmission.…”

“…209 Another study 210 found no effect of including gowns as part of CP on risk of MRSA transmission. The remaining studies 154,[211][212][213][214] found no difference in the rate of MRSA acquisition associated with discontinuation of CP for known MRSA patients.…”