Assadian Ojan, Sigmund Fabiola, Herzog Daniela, Riedl Karin, Klaus Christoph
Regional Hospital Wiener Neustadt, 2700 Wiener Neustadt, Austria.
Institute for Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield HD1 3DH, UK.
Antibiotics (Basel). 2023 Dec 13;12(12):1724. doi: 10.3390/antibiotics12121724.
The targeted or universal decolonization of patients through octenidine for nasal treatment and antiseptic body wash for 3 to 5 days prior elective surgery has been implemented in several surgical disciplines in order to significantly reduce surgical site infections (SSIs) caused by carriage. However, as most healthcare facilities also screen patients on admission for pilot infection, it is imperative that a prophylactic nasal decolonization procedure not yield a false negative SARS-CoV-2 status in otherwise positive patients. We assessed the effect of a commercially available octenidine-containing nasal gel on two different screening methods-antigen (Ag) detection based on colloidal gold immunochromatography and RT-PCR-in a prospective-type accuracy pilot study in asymptomatic SARS-CoV-2-positive inpatients. All patients still showed a positive test result after using the octenidine-containing nasal gel for about 3 days; therefore, its application did not influence SARS-CoV-2 screening, which is of high clinical relevance. Of note is that Ag detection was less sensitive, regardless of the presence of octenidine. From an infection prevention perspective, these results favor octenidine-based decolonization strategies, even during seasonal SARS-CoV-2 periods. As only asymptomatic patients are considered for elective interventions, screening programs based on RT-PCR technology should be preferred.
为显著减少因携带病原菌引起的手术部位感染(SSIs),在多个外科领域已实施针对患者的靶向或普遍去定植策略,即在择期手术前3至5天使用奥替尼啶进行鼻腔治疗并使用抗菌沐浴露。然而,由于大多数医疗机构在患者入院时也会对其进行感染筛查,因此预防性鼻腔去定植程序不能在原本呈阳性的患者中产生SARS-CoV-2假阴性结果,这一点至关重要。在一项针对无症状SARS-CoV-2阳性住院患者的前瞻性准确性初步研究中,我们评估了一种市售含奥替尼啶的鼻腔凝胶对两种不同筛查方法——基于胶体金免疫层析的抗原(Ag)检测和逆转录聚合酶链反应(RT-PCR)——的影响。所有患者在使用含奥替尼啶的鼻腔凝胶约3天后仍显示阳性检测结果;因此,其应用不会影响SARS-CoV-2筛查,这具有很高的临床相关性。值得注意的是,无论是否存在奥替尼啶,Ag检测的敏感性都较低。从感染预防的角度来看,即使在季节性SARS-CoV-2流行期间,这些结果也支持基于奥替尼啶的去定植策略。由于仅考虑无症状患者进行择期干预,基于RT-PCR技术的筛查方案应作为首选。