Randomized comparison of 2 protocols to prevent acquisition of methicillin-resistant Staphylococcus aureus: results of a 2-center study involving 500 patients
| Autor: | R. Thomas, Bernard Branger, Annick Legras, Dominique Perrotin, Eric Bellissant, Yves Le Tulzo, Sylvain Lavoué, Pascal Le Corre, Alain Renault, Christophe Camus, Pierre-Yves Donnio, Arnaud Gacouin |
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| Přispěvatelé: | Brébion, Alice, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Microbiologie : Risques Infectieux, Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Microenvironnement et cancer (MiCa), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
Pediatrics Epidemiology medicine.disease_cause law.invention Patient Isolation chemistry.chemical_compound MESH: Infection Control Randomized controlled trial law Hygiene media_common MESH: Aged Cross Infection MESH: Middle Aged Chlorhexidine MESH: Mupirocin MESH: Nose Middle Aged Staphylococcal Infections Intensive care unit Anti-Bacterial Agents 3. Good health MESH: Chlorhexidine Intensive Care Units Mupirocin Infectious Diseases [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology MESH: Guideline Adherence Female France Guideline Adherence Methicillin-Resistant Staphylococcus aureus Microbiology (medical) medicine.medical_specialty Isolation (health care) media_common.quotation_subject MESH: Staphylococcal Infections MESH: Methicillin-Resistant Staphylococcus aureus Nose MESH: Anti-Infective Agents Local MESH: Anti-Bacterial Agents medicine Humans Hospitals Teaching [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology Aged Protocol (science) Infection Control MESH: Humans business.industry MESH: Cross Infection MESH: Hospitals Teaching Methicillin-resistant Staphylococcus aureus MESH: Male MESH: Patient Isolation Clinical trial MESH: France chemistry Emergency medicine Anti-Infective Agents Local MESH: Intensive Care Units business MESH: Female |
| Zdroj: | Infection Control and Hospital Epidemiology Infection Control and Hospital Epidemiology, 2011, 32 (11), pp.1064-1072. ⟨10.1086/662180⟩ Infection Control and Hospital Epidemiology, University of Chicago Press, 2011, 32 (11), pp.1064-1072. ⟨10.1086/662180⟩ |
| ISSN: | 0195-9417 0899-823X 1559-6834 |
| DOI: | 10.1086/662180⟩ |
| Popis: | Objective.To compare an interventional protocol with a standard protocol for preventing the acquisition of methicillin-resistantStaphylococcus aureus(MRSA) in the intensive care unit (ICU).Design.Prospective, randomized, controlled, parallel-group, nonblinded clinical trial.Setting.Medical ICUs of 2 French university hospitals.Participants.Five hundred adults with an expected length of stay in the ICU greater than 48 hours.Interventions.For the intervention group, the protocol required repeated MRSA screening, contact and droplet isolation precautions for patients at risk for MRSA at ICU admission and for MRSA-positive patients, and decontamination with nasal mupirocin and chlorhexidine body wash for MRSA-positive patients. For the standard group, the standard precautions protocol was used, and the results of repeated MRSA screening in the standard group were not communicated to investigators.Main Outcome Measure.MRSA acquisition rate in the ICU. An audit was conducted to assess compliance with hygiene and isolation precautions.Results.In the intent-to-treat analysis (n= 488), the MRSA acquisition rate in the ICU was similar in the standard (13 [5.3%] of 243) and intervention (16 [6.5%] of 245) groups (P=.58). The audit showed that the overall compliance rate was 85.5% in the standard group and 84.1% in the intervention group (P=.63), although compliance was higher when isolation precautions were absent than when they were in place (88.2% vs 79.1%;PP=.01).Conclusions.Individual allocation to MRSA screening, isolation precautions, and decontamination do not provide individual benefit in reducing MRSA acquisition, compared with standard precautions, although the collective risk was lower during the periods of isolation.Trial Registration.Clinicaltrials.gov identifier: NCT00151606. |
| Databáze: | OpenAIRE |
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