Details:

Alternative Title:
Infect Control Hosp Epidemiol
Publisher's site:
http://dx.doi.org/10.1017/ice.2016.138
Personal Author:
Cluzet, Valerie C. ; Gerber, Jeffrey S. ; Metlay, Joshua P. ; Nachamkin, Irving ; Zaoutis, Theoklis E. ; ... More +
Cluzet, Valerie C. ; Gerber, Jeffrey S. ; Metlay, Joshua P. ; Nachamkin, Irving ; Zaoutis, Theoklis E. ; Davis, Meghan F. ; Julian, Kathleen G. ; Linkin, Darren R. ; Coffin, Susan E. ; Margolis, David J. ; Hollander, Judd E. ; Bilker, Warren B. ; Han, Xiaoyan ; Mistry, Rakesh D. ; Gavin, Laurence J. ; Tolomeo, Pam ; Wise, Jacqueleen A. ; Wheeler, Mary K. ; Hu, Baofeng ; Fishman, Neil O. ; Royer, David ; Lautenbach, Ebbing Less -
Corporate Authors:
CDC Prevention Epicenters Program
Description:
OBJECTIVE.

To determine the impact of total household decolonization with intranasal mupirocin and chlorhexidine gluconate body wash on recurrent methicillin-resistant Staphylococcus aureus (MRSA) infection among subjects with MRSA skin and soft-tissue infection.

DESIGN.

Three-arm nonmasked randomized controlled trial.

SETTING.

Five academic medical centers in Southeastern Pennsylvania.

PARTICIPANTS.

Adults and children presenting to ambulatory care settings with community-onset MRSA skin and soft-tissue infection (ie, index cases) and their household members.

INTERVENTION.

Enrolled households were randomized to 1 of 3 intervention groups: (1) education on routine hygiene measures, (2) education plus decolonization without reminders (intranasal mupirocin ointment twice daily for 7 days and chlorhexidine gluconate on the first and last day), or (3) education plus decolonization with reminders, where subjects received daily telephone call or text message reminders.

MAIN OUTCOME MEASURES.

Owing to small numbers of recurrent infections, this analysis focused on time to clearance of colonization in the index case.

RESULTS.

Of 223 households, 73 were randomized to education-only, 76 to decolonization without reminders, 74 to decolonization with reminders. There was no significant difference in time to clearance of colonization between the education-only and decolonization groups (log-rank P =.768). In secondary analyses, compliance with decolonization was associated with decreased time to clearance (P = .018).

CONCLUSIONS.

Total household decolonization did not result in decreased time to clearance of MRSA colonization among adults and children with MRSA skin and soft-tissue infection. However, subjects who were compliant with the protocol had more rapid clearance.


Subjects:
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Academic Medical Centers Administration, Intranasal Adolescent Adult Aged Anti-Bacterial Agents Anti-Infective Agents, Local Chlorhexidine Community-Acquired Infections Family Characteristics Family Health Humans Kaplan-Meier Estimate Male Methicillin-Resistant Staphylococcus Aureus Middle Aged Mupirocin Patient Compliance Patient Education As Topic Recurrence Soft Tissue Infections Staphylococcal Infections Staphylococcal Skin Infections Young Adult
Source:
Infect Control Hosp Epidemiol. 37(10):1226-1233
Pubmed ID:
27465112
Pubmed Central ID:
PMC9906270
Document Type:
Journal Article
Funding:
K24 AI080942/AI/NIAID NIH HHSUnited States/ ; U54 CK000163/CK/NCEZID CDC HHSUnited States/
K24 AI080942/AI/NIAID NIH HHSUnited States/ ; U54 CK000163/CK/NCEZID CDC HHSUnited States/ Less -
Place as Subject:
Pennsylvania
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:60849d50891414d938e16a4bcf3c45fc21e1d3b554a8086d0c8cf8f58e894139
Download URL:
https://stacks.cdc.gov/view/cdc/124430/cdc_124430_DS1.pdf
File Type:

Supporting Files

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  	NIHMS1865999-supplement-cluzet3.tiff	tiff
  	NIHMS1865999-supplement-cluzet4.tiff	tiff
  	NIHMS1865999-supplement-cluzet5.tiff	tiff
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