Colonization with Methicillin-Resistant Staphylococcus aureus (MRSA) is independently is associated with mortality in critically ill adults. Tea tree has broad bactericidal activity. Clinical evidence supports its efficacy in eradicating MRSA, but there are no published data on its role in preventing MRSA colonization.
To determine whether the daily use of 5% tea tree oil compared with standard care (soap and water) had a lower incidence of Methicillin-Resistant Staphylococcus aureus colonization.
A quasi-experimental design was utilized and conducted at the neurological, intensive care units at Mansoura University Hospital including 120 adult critically ill patients participated in the study.
There were highly statistically significant differences between the study and control groups on the seventh day. So, all the study group subjects’ swabs from nose and groin were free from MRSA, while all the control group subjects’ swabs showed positive for MRSA infection. Tea tree oil is effective in preventing MRSA infection. Therefore, the establishment of using tea tree oil in the prevention of MRSA infection and further researches are highly recommended on a larger probability sample in the different geographical hospitals in Egypt to ensure generalization of findings.
MRSA is a major nosocomial pathogen that causes severe morbidity and mortality rate in many hospitalized patients especially critically ill patients and considered one of the main causes of the death worldwide [1]. It is the leading cause of life threating problems such as bloodstream infection, pneumonia, surgical site infection, arthritis, osteomyelitis, and endocarditis if not treated quickly; MRSA can cause sepsis and death [2,3]. Moreover, MRSA infection leads to increased hospitalization length and health care costs [4]. Its prevalence in Egypt is high compared to other African countries. Its prevalence of HA-MRSA increased from 48.5% in 2005 to 69.1% in 2013 and CA-MRSA 23.3% to 60% [5]. Furthermore, about two billion people worldwide carry Staphylococcus aureus, between 2 million and 53 million people in the United States (USA) carry MRSA [6]. Mortality rate due to MRSA is 50 % and higher for patients infected with MRSA in intensive care unit [7]. According to centers for disease control and Prevention (CDC) approximately 2.3 million individuals in the USA diagnosed with MRSA, approximately 86% of persons diagnosed with MRSA associated nosocomial or health care infection and 14% were community infection, 94,000 cases are MRSA infection and 11,000 dies from MRSA infection in the USA each year [8]. Approximately 25-35 % of the populations carry Staphylococcus aureus bacteria on the skin or nose is generally harmless, the bacteria enter the body through a cut of the skin or another open wound [9]. MRSA infection symptoms generally begin as swollen, painful red bumps that may resemble pimples or spider bites. In addition, it has a wide range of symptoms depending on the infected part of the body. The affected area may be redness, warm to touch, abscess and fever [10]. Critically ill patients usually are exposed to a number of intrinsic and extrinsic factors in ICU increased risk of MRSA. Typically, the patients have multiple invasive procedures or devices as intravenous tubing, hemodialysis catheters, urinary catheters, mechanical ventilation and tracheotomy that may contribute to limitation of patients positioning and mobility, even so, increasing the risk of MRSA occurrence [11]. Moreover, length of ICU stay, antibiotic use, diminished immune response, old age, superficial wound, MRSA colonization adds to comorbidity as diabetes and chronic disease side by side with the patient underlying disease contribute to MRSA development [12]. Additionally, it has been noted that health care workers have an increased risk of colonization and contribute to the transmission of MRSA infections in hospitals [13]. Today, MRSA is not a response to antibiotics therapy; it becomes resistant to beta-lactam antibiotics and causes serious complications [14]. In recent years, natural products such as herbal medicine and essential oil spread increasingly owning to plant naturally derived oil like tea tree oil (TTO). it’s a safe and effective herbal source of therapeutic help in the health care system all over the world [15]. TTO has antimicrobial, antifungal and antiviral, and anti-inflammatory properties due to the presence of a compound that is known terpinene-4 [16,17]. In addition, TTO is safe and well tolerated by patients, and considered as an alternative therapy to prevent and treat MRSA infection [18].
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