| Autor: |
David, Michael Z., Siegel, Jane D., Henderson, Janet, Leos, Greg, Lo, Kaming, Iwuora, Jerry, Porsa, Esmaeil, Schumm, L. Philip, Boyle-Vavra, Susan, Daum, Robert S. |
| Zdroj: |
Infection Control & Hospital Epidemiology; December 2014, Vol. 35 Issue: 12 p1466-1473, 8p |
| Abstrakt: |
Objective.To assess an intervention to limit community-associated methicillin-resistant Staphylococcus aureus(MRSA) dissemination.Design.Randomized, controlled trial.Setting.County Jail, Dallas, Texas.Participants.A total of 4,196 detainees in 68 detention tanks.Methods.Tanks were randomly assigned to 1 of 3 groups: in group 1, detainees received cloths that contained chlorhexidine gluconate (CHG) to clean their entire skin surface 3 times per week for 6 months; group 2 received identical cloths containing only water; and group 3 received no skin treatment. During the study, all newly arrived detainees were invited to enroll. Nares and hand cultures were obtained at baseline and from all current enrollees at 2 and 6 months.Results.At baseline, S. aureuswas isolated from 41.2% and MRSA from 8.0% (nares and/or hand) of 947 enrollees. The average participation rate was 47%. At 6 months, MRSA carriage was 10.0% in group 3 and 8.7% in group 1 tanks (estimated absolute risk reduction [95% confidence interval (CI)], 1.4% [−4.8% to 7.1%]; P= .655). At 6 months, carriage of any S. aureuswas 51.1% in group 3, 40.7% in group 1 (absolute risk reduction [95% CI], 10.4% [0.01%–20.1%]; P= .047), and 42.8% (absolute risk reduction [95% CI], 8.3% [−1.4% to 18.0%]; P= .099) in group 2.Conclusions.Skin cleaning with CHG for 6 months in detainees, compared with no intervention, significantly decreased carriage of S. aureus, and use of water cloths produced a nonsignificant but similar decrease. A nonsignificant decrease in MRSA carriage was found with CHG cloth use.Trial registration.ClinicalTrials.gov identifier NCT00785200. |
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