Methodologic considerations of household-level methicillin-resistant Staphylococcus aureus decolonization among persons living with HIV
| Autor: | Jill N Anderson, Jason E. Farley, Nancy Perrin, Kelly Lowensen, Tracy L. Ross, Laura E. Starbird, Karen C. Carroll |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Male Methicillin-Resistant Staphylococcus aureus Pediatrics medicine.medical_specialty Referral Epidemiology 030106 microbiology Population Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Medicine Humans 030212 general & internal medicine Prospective Studies education education.field_of_study Family Characteristics business.industry Health Policy Chlorhexidine Public Health Environmental and Occupational Health biochemical phenomena metabolism and nutrition Middle Aged Staphylococcal Infections bacterial infections and mycoses Methicillin-resistant Staphylococcus aureus Anti-Bacterial Agents Clinical trial Regimen Infectious Diseases Mupirocin Treatment Outcome Family medicine Carrier State Female business Decolonization |
| Popis: | Background People living with HIV (PLWH) have a higher prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization and likelihood of recurrent infection than the general population. Simultaneously treating MRSA-colonized household members may improve success with MRSA decolonization strategies. This article describes a pilot trial testing household-level MRSA decolonization and documents methodologic and pragmatic challenges of this approach. Methods We conducted a randomized controlled trial of individual versus individual-plus-household MRSA decolonization to reduce recurrent MRSA. PLWH with a history of MRSA who are patients of an urban HIV clinic received a standard MRSA decolonization regimen. MRSA colonization at 6 months was the primary outcome. Results One hundred sixty-six patients were referred for MRSA screening; 77 (46%) enrolled. Of those, 28 (36%) were colonized with MRSA and identified risk factors consistent with the published literature. Eighteen were randomized and 13 households completed the study. Conclusions This is the first study to report on a household-level MRSA decolonization among PLWH. Challenges included provider referral, HIV stigma, confidentiality concerns over enrolling households, and dynamic living situations. Although simultaneous household MRSA decolonization may reduce recolonization, recruitment and retention challenges specific to PLWH limit the ability to conduct household-level research. Efforts to minimize these barriers are needed to inform evidence-based practice. |
| Databáze: | OpenAIRE |
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