Scientists should investigate whether saturating the skin with 'good' bacteria would offer better protection against deadly germs, says the paper. Professor Mark Spigelman, of the UCL Centre for Infectious Diseases and International Health, is calling for a study to be set up in hospital units in which antibiotics would be banned, to explore alternative health protection measures against MRSA.
In the paper, published in the November issue of Annals of the Royal College of Surgeons, Professor Spigelman says the time has come to re-evaluate the concept of using antibiotics and scrubbing hands and wounds with antiseptic soaps. His paper outlines a six-point proposal to set up surgical hospitals which would be antibiotic-free and would instead comply with the novel standard practices being investigated.
Professor Mark Spigelman says: "Inappropriate use of antibiotics remains a major problem, despite our ever-growing understanding of how bacteria behave. For example, any student who has grown bacteria in a lab will know that they generally do not grow on top of one another. So when we wash our hands, we could actually be killing off harmless commensals to the extent that we leave space for other bacteria, such as MRSA strains, to settle.
"Perhaps we should be thinking about using probiotics and even dipping our hands after thorough washing into a solution which contains harmless bacteria, which could then colonise our skin and prevent pathogenic bacteria from settling on it.
"It must be remembered that after almost 40 years, MRSA has not become widespread except in hospitals where we use the most advanced antibiotics and most rigorous antiseptic measures. Why is this? More of the same does not seem to be working - new antibiotics and antibacterial soaps have not stopped MRSA.
"The idea may sound absurd, but I believe that a probiotic cleaning procedure is an avenue worth exploring. To overcome the current epidemic of MRSA and other bacteria, we should aim to set up a handful of hospitals where the use of antibiotics would be banned, and any patients who needed them would be transferred to an antibiotic-using hospital. Doctors from these hospitals would not be allowed to enter hospitals which use antibiotics.
"At the same time we could trial the benefits of using 'good' bacteria to saturate the skin on doctors' hands and even patients' wounds prior to surgery, to see if this would prevent the settling of pathogenic, antibiotic-resistant bacteria. For instance, a surgeon who has spent the morning repeatedly scrubbing his or her hands in an operating theatre may well have got rid of many harmless skin commensals. When the surgeon then goes to the wards, the more virulent bacteria may settle into the areas left vacant. As a first step, the surgeon could use probiotics to try and prevent this sequence of events, for example by dipping their hands into a probiotic substance such as yoghurt."
Notes for Editors:
1. For more information, please contact Judith Moore at the UCL Media Relations Office on +44 (0)207 679 7678, mobile +44 (0)7733 307596, out-of-hours +44 (0)7917 271 364, e-mail email@example.com.
2. Spigelman M. 'MRSA - Why treat the symptoms and not the disease?' is published in the Annals of The Royal College of Surgeons of England 2005; 87(5): 452-453 and can be found at http://dx.
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About the Annals of The Royal College of Surgeons of England
The Annals is the official journal of The Royal College of Surgeons of England and is published bimonthly in January, March, May, July, September and November. The main aim of the journal is to publish high-quality peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters, comments, a regular technical section, the best trainee presentations from England and Wales, book reviews and a surgical website review forum. The Annals editorial committee comprises members of the College Council, trainees and experts from across the surgical specialties. Each subscription to the Annals includes 10 issues per year of the Bulletin of The Royal College of Surgeons of England with news of College events and discussion of topical surgical issues.