Staphylococcus Aureus Clinical Trial
Official title:
Household vs. Individual Approach to Decolonization of Community-acquired Methicillin-resistant Staphylococcus Aureus.
The purpose of this study is to determine whether measures to eliminate the Staph germ from the skin of the index patient (with a special ointment and soap) are more effective when performed by everyone in the household rather than the patient alone, and whether these methods are effective in preventing future Staph infections. The investigators hypothesize that there will be a greater number of households who are successful in eradicating the staph germ from the index patient when all members of the household participate than households where only the index patient is treated.
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).
CA-MRSA has become a major source of morbidity and mortality in our pediatric population. An
important prerequisite for S. aureus infection may be nasal carriage of the organism. A
variety of decolonization strategies have been used for infection prophylaxis, primarily in
patients undergoing hemodialysis or surgery, with varying results. However, there are no
published randomized eradication trials evaluating the decolonization and prevention of
CA-MRSA infections in immunocompetent children in the outpatient setting. While the
transmission of CA-MRSA within households has been reported, its contribution to recurrent
CA-MRSA infection among household members is undetermined. The investigators hypothesize
that spread of CA-MRSA among household members leads to recolonization or failure of
decolonization in children undergoing eradication efforts.
Specific Aim: In pediatric patients presenting with a MRSA skin or soft tissue infection,
compare the effectiveness of decolonization measures performed by an entire household in
comparison to measures directed at the index patient alone. The investigators will conduct a
randomized, controlled trial to test the hypothesis that decolonization measures performed
by the entire household, specifically application of intranasal mupirocin ointment and
bathing with chlorhexidine liquid soap, in addition to education and basic hygiene
interventions, will be twice as effective in eradicating CA-MRSA carriage in the index
patient than if the measures are performed only by the index patient.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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