Individualized vs. Household MRSA Decolonization
| Status: | Completed |
|---|---|
| Conditions: | Infectious Disease |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 2/23/2019 |
| Start Date: | April 2013 |
| End Date: | November 28, 2017 |
Individualized vs. Household Eradication of MRSA in Households With Children
The purpose of this research study is to compare the effectiveness of commonly used
decolonization treatments (application of mupirocin antibiotic ointment to the nose and
bleach baths) when performed by individuals with a history of skin and soft tissue infection
(SSTI) in the prior year (individualized approach) in comparison to decolonization of all
household members (household approach) in an attempt to prevent Staphylococcus aureus skin
infections. The investigators hypothesize an individualized decolonization approach will be
equally as effective as a household approach to prevent SSTI.
decolonization treatments (application of mupirocin antibiotic ointment to the nose and
bleach baths) when performed by individuals with a history of skin and soft tissue infection
(SSTI) in the prior year (individualized approach) in comparison to decolonization of all
household members (household approach) in an attempt to prevent Staphylococcus aureus skin
infections. The investigators hypothesize an individualized decolonization approach will be
equally as effective as a household approach to prevent SSTI.
Methicillin-resistant Staphylococcus aureus (MRSA) was once uniformly associated with
hospital-acquired infections; however, MRSA strains have emerged that thrive outside the
hospital environment, causing significant morbidity and mortality among immunocompetent
individuals, leading to their designation as community-acquired methicillin resistant
Staphylococcus aureus (CA-MRSA).
There is no available vaccine against S. aureus. Thus, other preventive measures, including
topical antimicrobial therapies, have been used in an attempt to prevent staphylococcal
infections. These therapies include mupirocin (a topical antibiotic with activity against
MRSA) and dilute bleach water baths. The effectiveness of these measures directed at patients
colonized with traditional MSSA and HA-MRSA strains in an attempt to prevent nosocomial
infections varies across studies, and maintenance of eradication diminishes over time. With
the emergence of the CA-MRSA epidemic, these measures have been extrapolated to patients in
community settings. We aim to find a practical approach to decolonization which patients can
feasibly perform at home to reduce the incidence of skin and soft tissue infections(SSTI).
Specific Aim: Compare the effectiveness of decolonization of individuals with a history of
SSTI in the prior year (individualized approach) to decolonization of all household members
(household approach) in reducing the incidence of recurrent SSTI. Primary hypothesis: An
individualized decolonization approach will be equally as effective as decolonization of all
household members to prevent SSTI. Secondary hypothesis: Application of mupirocin to the
anterior nares twice daily for 5 days will not result in a higher prevalence of colonization
with mupirocin-resistant strains at subsequent longitudinal samplings.
hospital-acquired infections; however, MRSA strains have emerged that thrive outside the
hospital environment, causing significant morbidity and mortality among immunocompetent
individuals, leading to their designation as community-acquired methicillin resistant
Staphylococcus aureus (CA-MRSA).
There is no available vaccine against S. aureus. Thus, other preventive measures, including
topical antimicrobial therapies, have been used in an attempt to prevent staphylococcal
infections. These therapies include mupirocin (a topical antibiotic with activity against
MRSA) and dilute bleach water baths. The effectiveness of these measures directed at patients
colonized with traditional MSSA and HA-MRSA strains in an attempt to prevent nosocomial
infections varies across studies, and maintenance of eradication diminishes over time. With
the emergence of the CA-MRSA epidemic, these measures have been extrapolated to patients in
community settings. We aim to find a practical approach to decolonization which patients can
feasibly perform at home to reduce the incidence of skin and soft tissue infections(SSTI).
Specific Aim: Compare the effectiveness of decolonization of individuals with a history of
SSTI in the prior year (individualized approach) to decolonization of all household members
(household approach) in reducing the incidence of recurrent SSTI. Primary hypothesis: An
individualized decolonization approach will be equally as effective as decolonization of all
household members to prevent SSTI. Secondary hypothesis: Application of mupirocin to the
anterior nares twice daily for 5 days will not result in a higher prevalence of colonization
with mupirocin-resistant strains at subsequent longitudinal samplings.
Inclusion Criteria:
- Individuals who are enrolled in a 12-month observational study entitled "The
Community-Associated Methicillin-Resistant Staphylococcus aureus Among Household
Members and the Home Environment Study."
Exclusion Criteria:
- Households in which all members experienced SSTI during the 12-month observational
study
- Individuals with known allergies to mupirocin or bleach (sodium hypochlorite)
We found this trial at
1
site
660 S Euclid Ave
Saint Louis, Missouri 63110
Saint Louis, Missouri 63110
(314) 362-5000
Washington University School of Medicine Washington University Physicians is the clinical practice of the School...
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