Control of MRSA in Nursing Homes: Decolonization vs Standard Precautions

Methicillin-Resistant Staphylococcus Aureus Clinical Trial

Official title:

Universal Screening and Decolonization vs Standard Precautions for Control of Methicillin-resistant Staphylococcus Aureus (MRSA) in Nursing Homes: a Cluster, Randomised Controlled Study.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01138462
• Other study ID #: Protocole 96/10
• Status: Completed
• Phase: N/A
• Start date: June 2010
• Est. completion date: December 2011

Study information

• Verified date: March 2020
• Source: University of Lausanne Hospitals
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine the better approach between the currently procedure (i.e. standards precautions) and a reinforced strategy to control MRSA transmission in the institutionalized population of nursing homes in Canton of Vaud, Switzerland.

Description:

MRSA carriage among nursing homes residents of Canton Vaud, Switzerland, is increasing, despite use of standard precautions. Recommendation to prevent MRSA transmission in long term care facilities are lacking. We aim to reinforce the current infection control strategy by general MRSA screening of institutionalised residents and decolonisation of MRSA carriers. Because the uncertainties in the impact of this reinforced strategy, we aim to compare this action to the policy actually applied.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 157
• Est. completion date: December 2011
• Est. primary completion date: December 2011
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• all nursing homes of canton Vaud, Switzerland, that give the consent of participation

Exclusion Criteria:

• refusal to participate

Inclusion criteria for decolonisation in intervention nursing homes:

• all MRSA positive residents living in a Nursing Home included in the intervention group

Exclusion Criteria for decolonisation:

• residents that refuse to be screened or refused the decolonisation

• life expectancy shorter of 7 days

• known intolerance of disinfectant/ topical antibiotics used in the protocol

• active MRSA infection

• asymptomatic MRSA bacteriuria

• stage IV wound (according to National Pressure Ulcer Advisory Panel)

Related Conditions & MeSH terms

• Methicillin-Resistant Staphylococcus Aureus
• Staphylococcal Infections

Intervention

Other:
• intervention
5 days topical decolonisation including nasal mupirocin tid, chlorhexidine mouth wash tid, chlorhexidine body wash once daily. Daily direct resident's environmental disinfection during decolonisation.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
University of Lausanne Hospitals

References & Publications (1)

Bellini C, Petignat C, Masserey E, Büla C, Burnand B, Rousson V, Blanc DS, Zanetti G. Universal screening and decolonization for control of MRSA in nursing homes: a cluster randomized controlled study. Infect Control Hosp Epidemiol. 2015 Apr;36(4):401-8. doi: 10.1017/ice.2014.74. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	To determine the change in prevalence of MRSA carriage among residents of each Nursing homes group at the end of the one study year	in each control and intervention nursing home: MRSA screening of all residents of nursing homes of Canton Vaud, at baseline and 1 year later, in order to compare MRSA prevalence changes at nursing homes levels	1 year
Secondary	To determine the effectiveness of the reinforced strategy to prevent MRSA infection, compared to the standard strategy	In a subpopulation of all nursing homes residents (10% of the whole population), recording of all microbiologically documented MRSA infection, according to nosocomial infection definitions of the Center of Diseases Control (CDC) of Atlanta.	1 year