title: Laser-assisted nasal decolonization of Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus.
abstract: OBJECTIVE
  Methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant S aureus (MRSA) contribute to 25% of nosocomial infections, increasing complications, health care cost, and growing antibiotic resistance. Nasal decolonization (ND) can reduce the staphylococcal infection rate. A new method of laser therapy (LT) MRSA ND was tested.
  
  
  METHODS
  This is a prospective, nonrandomized study.
  
  
  METHODS
  Following institutional review board approvals, 25 patients colonized with MSSA/MRSA were allocated to 4 treatment arms; low-power, dual-wavelength 870-/930-nm laser alone (GR1); low-power, dual-wavelength laser followed by erythromycin (E-mycin) cream (GR2); low-power, dual-wavelength laser followed by peroxide irrigation (GR3); and high-power 940-nm laser alone (GR4). Quantitative cultures were obtained before and after in all arms. Laser therapy was performed via a laser fiber diffuser, delivering 200 to 600 J/cm² to each naris circumferentially. Patient's distribution was 3 in GR1, 14 in GR2, 4 in GR3, and 4 in GR4 (last 10 recruited to GR4).
  
  
  RESULTS
  Nasal decolonization for GR1, GR2, GR3, and GR4 was 1 of 3, 13 of 14, 2 of 4, and 4 of 4, respectively. Because LT + E-mycin cleared all first 3 patients of MRSA and MSSA, all remaining patients were treated with LT + Er with over 90% of patients clearing. No adverse events or discomfort were reported.
  
  
  CONCLUSIONS
  First human study using LT and topical E-mycin in ND is presented. Laser therapy can eradicate MRSA and potentially resensitization of bacteria to the antimicrobial effect of erythromycin. Although decolonization was maintained at 4 weeks posttreatment, further studies can determine the LT long-term effect.
authors.affiliation: Lennox Hill Hospital, New York, NY, USA. krespi@nyhni.org
authors.forename: Yosef P
authors.initials: YP
authors.lastname: Krespi
authors.forename: Victor
authors.initials: V
authors.lastname: Kizhner
mesh_terms: D015169:Colony Count, Microbial; D003428:Cross Infection / Q000382:microbiology / Q000532:radiotherapy*; D005500:Follow-Up Studies; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000254:growth & development / Q000302:isolation & purification / Q000528:radiation effects*; D011446:Prospective Studies; D012220:Rhinitis / Q000382:microbiology / Q000532:radiotherapy*; D013203:Staphylococcal Infections / Q000382:microbiology / Q000532:radiotherapy*; D016896:Treatment Outcome