Interventions targeting the nasal microbiome to eradicate methicillin-resistant Staphylococcusaureus.

Background: Staphylococcus aureus is an important pathogen in many sites, including the bloodstream, skin and soft tissue, bone and joints. When infection is caused by methicillin-resistant S. aureus (MRSA), therapy is more difficult and outcomes are less favourable. Nasal colonization is associated with increased risk for MRSA infections. The nasal microbiome may play a role in risk for nasal colonization and infection.

Objectives: To review the role of the microbiome in MRSA nasal colonization and infection.

Sources: Peer-reviewed literature identified in a MEDLINE search using MRSA, S. aureus, prebiotic and microbiota as search terms.

Content: Reduction of S. aureus nasal colonization has been shown to reduce risk of S. aureus infections, but decolonization methods are imperfect. The role of the nasal microbiome in host defence against S. aureus colonization and infection is explored. Numerous organisms have been shown to be negatively associated with S. aureus colonization. The antimicrobial molecules produced by these organisms are an active area of research.

Implications: Future research should focus on development of safe and effective molecules that can inhibit S. aureus in the nasal vestibule. Damage to the diverse nasal microbiota by unnecessary antibiotics should be avoided.