Topical Decolonization Does Not Eradicate the Skin Microbiota of Community-Dwelling or Hospitalized Adults.
Topical antimicrobials are often employed for decolonization and infection prevention and may alter the endogenous microbiota of the skin. The objective of this study was to compare the microbial communities and levels of richness and diversity in community-dwelling subjects and intensive care unit (ICU) patients before and after the use of topical decolonization protocols. We enrolled 15 adults at risk for Staphylococcus aureus infection. Community subjects (n = 8) underwent a 5-day decolonization protocol (twice daily intranasal mupirocin and daily dilute bleach-water baths), and ICU patients (n = 7) received daily chlorhexidine baths. Swab samples were collected from 5 anatomic sites immediately before and again after decolonization. A variety of culture media and incubation environments were used to recover bacteria and fungi; isolates were identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry. Overall, 174 unique organisms were recovered. Unique communities of organisms were recovered from the community-dwelling and hospitalized cohorts. In the community-dwelling cohort, microbial richness and diversity did not differ significantly between collections across time points, although the number of body sites colonized with S. aureus decreased significantly over time (P = 0.004). Within the hospitalized cohort, richness and diversity decreased over time compared to those for the enrollment sampling (from enrollment to final sampling, P = 0.01 for both richness and diversity). Topical antimicrobials reduced the burden of S. aureus while preserving other components of the skin and nasal microbiota.
Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.|Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, Missouri, USA.
C A
0000-0002-1137-840X
CA
Burnham
Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.
Patrick G
PG
Hogan
Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, Missouri, USA.
Meghan A
MA
Wallace
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
Elena
E
Deych
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
William
W
Shannon
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
David K
DK
Warren
Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA Fritz_S@kids.wustl.edu.
Stephanie A
0000-0002-8602-5879
SA
Fritz
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000627:therapeutic use*; D003428:Cross Infection / Q000517:prevention & control; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D064307:Microbiota / Q000187:drug effects*; D008875:Middle Aged; D016712:Mupirocin / Q000627:therapeutic use*; D009666:Nose / Q000382:microbiology; D012867:Skin / Q000382:microbiology*; D012973:Sodium Hypochlorite / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D016712:Mupirocin; D012973:Sodium Hypochlorite; D002710:Chlorhexidine
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