Quality improvement study on the effectiveness of intranasal povidone-iodine decolonization on surgery patients.

BACKGROUND

Surgical site infection prevention and treatment remains a challenge in healthcare settings globally. The routine use of intranasal mupirocin for decolonization has challenges and preoperative intranasal povidone-iodine decolonization is another option. The purpose of this quality improvement study was to assess if a one-time preoperative intranasal povidone-iodine application could reduce the risk of the likelihood of nasal carriage of after surgery.

METHODS

Ambulatory Surgery Center patients were enrolled in an intranasal povidone-iodine decolonization quality improvement study as they reported at the pre-operative holding area. Pre-decolonization intranasal samples were collected, followed by intranasal application of povidone-iodine. Patients waited for a minimum of 20 minutes after application before proceeding with surgery. Nasal samples were again collected after surgery. Each sample was tested for colonization using the 16S rRNA-mecA-nuc triplex polymerase chain reaction, standard biochemical tests, and qualitative culturing.

FINDINGS

In the 98 patients enrolled, 36% of these patients had intranasal colonization with by 16S rRNA-mecA-nuc triplex polymerase chain reaction before surgery. Using a qualitative culture technique, 28% of patients tested positive for before surgery and 20% of patients tested positive for after surgery ( = 0.039).

CONCLUSION

Intranasal preoperative povidone-iodine is an effective strategy in the decolonization of from the nares if properly implemented.