The Effect of Total Household Decolonization on Clearance of Colonization With Methicillin-Resistant Staphylococcus aureus. (28th July 2016)

• Record Type: Journal Article
• Authors: 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
• Other Names: collab.
• Is Part Of: Infection control and hospital epidemiology. Volume 37:Number 10(2016)
• Page Start: 1226
• Page End: 1233
• Publication Date: 2016-07-28
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2016.138
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract : 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 Trial registration. ClinicalTrials.gov identifier: NCT00966446 Infect Control Hosp Epidemiol 2016;1–8