I went to the doc’s office for a checkup and we started discussing my migraine issue(s). I’m having a rhinoplasty in January to fix my crushed septum from a bike crash in 2001, and the plastic surgeon (not my GP) was asking for a CT sinus scan to see if I had any sinus issues, too, because I was having sinus pain above my eye where the helmet flattened. So my GP was asking me Q’s about this too, and he was wondering if I might have some lingering sinus infection even though I wasn’t showing any real symptoms of such. He then did something weird - took a culture specimen by inserting a swab a good 3.5 inches inside my nose! It was like a damned magic trick. He also put me on a quick regimen of a 5 day antibiotic “tequim”? (spelling?) just in case.
So while I’m there I show him this “pimple” that I had for about 4 weeks that wasn’t going away. He said whatever it was the antibiotic should get it.
So he calls me last night - tells me that they grew STAPH from the culture in my nose. I had a staph infection, and that was what that “pimple” was, too. Staph infection with no other symptoms? Yup, he said it happens. Told me the antibiotic surely killed it but I’d have to send my wife in for the same regimen otherwise I’d get it back again as she undoubtedly had it, too.
Lots of people have Staph growing in their nose. THAT is NOT an infection. It is a colonization. It can lead to infections, like the one on your nose. Many of these, nowadays, are resistant to the usually Staph antibiotics. Often, mupirocin (a topical antibiotic), is placed in the nose three times a day for 10-14 days to try to eliiminate the colonization.
If you suffer from recurrent skin infections, ask your doctor to culture your nose for bacteria. Most recurrent skin infections are caused by a germ called staph aureus and it often cannot be eradicated from your nose by conventional oral antibiotics.
Your doctor usually treats skin infections with antibiotic pills and injections, which readily clear germs from the skin, but oral and injected antibiotics rarely can clear staph aureus from your nose. Then, every time you sneeze or touch your nose, the spray deposits staph aureus on your hands where it goes back to your skin to start another infection. The vast majority of the time, your doctor can rid the germ from your nose and cure you by telling you to buy inexpensive bacitracin ointment bought over the counter without a prescription and to apply a small amount inside your nostrils for several weeks. Many doctors prescribe the far more expensive prescription ointment, mupiricin, because of the intense publicity that has been generated for its use (1,2,3).
When surgeons have staph aureus in their noses, they are usually not allowed to operate because the germ can get into surgical wounds. One of the most common causes of delayed wound healing. is an infection with staph aureus (4). It is also the most common cause of sore nipples in breast-feeding mothers (5). In one study, people with recurrent staph aureus infections were told to apply an antibiotic ointment into their noses for five days each month for one year (6). They finally got rid of the staph from their noses and stopped getting infections on their skin.
By Gabe Mirkin, M.D., for CBS Radio News
Archives of Internal Medicine July 11, 1994.
C Brunbuisson, A Rauss, P Legrand, H Mentec, M Ossart, F Eb, JP Sollet, F Leturdu, A Boillot, Y Michelbriand, JL Ricome, A Boisivon. Mupirocin Treatment of S Aureus Nasal Carriage and Prevention of Infection in Intensive Care Units: A Multicenter Controlled Study. Medecine et Maladies Infectieuses 24: 12 (DEC 1994):1229-1239.
C Watanakunakorn, C Axelson, B Bota, C Stahl. Mupirocin ointment with and without chlorhexidine baths in the eradication of Staphylococcus aureus nasal carriage in nursing home residents. American Journal of Infection Control 23: 5 (OCT 1995):306-309.
RP Wenzel, TM Perl. The significance of nasal carriage of Staphylococcus aureus and the incidence of postoperative wound infection. Journal of Hospital Infection 31: 1 (SEP 1995):13-24.
VH Livingstone, CE Willis, J Berkowitz. Staphylococcus aureus and sore nipples. Canadian Family Physician 42 (APR 1996):654-659.
R Raz, D Miron, R Colodner, Z Staler, Z Samara, Y Keness. A 1-year trial of nasal mupirocin in the prevention of recurrent staphylococcal nasal colonization and skin infection. Archives of Internal Medicine 156: 10 (MAY 27 1996):1109-1112.
MA Smith, JJ Mathewson, IA Ulert, EG Scerpella, CD Ericsson. Contaminated stethoscopes revisited. Archives of Internal Medicine 156: 1 (JAN 8 1996):82-84.
I’ve wondered that, but the only studies I’ve seen are with mupirocin, which is now available as a generic. While not a cheap as Bacitracin, it is a lot less than the trade name (Bactroban and Centany).
There is a nasal spray with an artificial sweetener, used a lot in Europe in chewing gum, that the manufacturer claims alters your nasal bacteria. I’m having a senior moment on the name of the stuff. (It is one of those non-absorbed sugar-alcohols.)