Randomized controlled trial of a self-administered five-day antiseptic bundle versus usual disinfectant soap showers for preoperative eradication of Staphylococcus aureus colonization
| Autor: | James R. Johnson, Shalini L Kulasingam, Selina Jawahir, Susan Kline, Kayleigh Dittes, James D. Neaton, Patricia Ferrieri, Alexander M. Kaizer, Anita Glennen, Jeremiah S Menk, Ruth Lynfield |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Bathing Epidemiology Mouthwashes Self Administration 030501 epidemiology law.invention Tertiary Care Centers chemistry.chemical_compound 0302 clinical medicine Antiseptic Randomized controlled trial law Clinical endpoint 030212 general & internal medicine Chlorhexidine Middle Aged Staphylococcal Infections Mupirocin Infectious Diseases medicine.anatomical_structure Carrier State Female Nasal Cavity 0305 other medical science Patient Care Bundles medicine.drug Adult Methicillin-Resistant Staphylococcus aureus Microbiology (medical) medicine.medical_specialty medicine.drug_class Minnesota Soaps 03 medical and health sciences Internal medicine Throat Preoperative Care medicine Humans Surgical Wound Infection Elective surgery Administration Intranasal Aged business.industry Baths Disinfection Logistic Models chemistry Anti-Infective Agents Local business |
| Zdroj: | Infection Control & Hospital Epidemiology. 39:1049-1057 |
| ISSN: | 1559-6834 0899-823X |
| Popis: | ObjectiveTo determine the efficacy in eradicating Staphylococcus aureus (SA) carriage of a 5-day preoperative decolonization bundle compared to 2 disinfectant soap showers, with both regimens self-administered at home.DesignOpen label, single-center, randomized clinical trial.SettingAmbulatory orthopedic, urologic, neurologic, colorectal, cardiovascular, and general surgery clinics at a tertiary-care referral center in the United States.ParticipantsPatients at the University of Minnesota Medical Center planning to have elective surgery and not on antibiotics.MethodsConsenting participants were screened for SA colonization using nasal, throat, axillary, and perianal swab cultures. Carriers of SA were randomized, stratified by methicillin resistance status, to a decolonization bundle group (5 days of nasal mupirocin, chlorhexidine gluconate [CHG] bathing, and CHG mouthwash) or control group (2 preoperative showers with antiseptic soap). Colonization status was reassessed preoperatively. The primary endpoint was absence of SA at all 4 screened body sites.ResultsOf 427 participants screened between August 31, 2011, and August 9, 2016, 127 participants (29.7%) were SA carriers. Of these, 121 were randomized and 110 were eligible for efficacy analysis (57 decolonization bundle group, 53 control group). Overall, 90% of evaluable participants had methicillin-susceptible SA strains. Eradication of SA at all body sites was achieved for 41 of 57 participants (71.9%) in the decolonization bundle group and for 13 of 53 participants (24.5%) in the control group, a difference of 47.4% (95% confidence interval [CI], 29.1%–65.7%; PConclusionAn outpatient preoperative antiseptic decolonization bundle aimed at 4 body sites was significantly more effective in eradicating SA than the usual disinfectant showers (ie, the control).Trial RegistrationClinicalTrials.gov identifier: NCT02182115 |
| Databáze: | OpenAIRE |
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