Household versus individual approaches to eradication of community-associated Staphylococcus aureus in children: a randomized trial.
نویسندگان
چکیده
BACKGROUND Community-associated Staphylococcus aureus infections often affect multiple members of a household. We compared 2 approaches to S. aureus eradication: decolonizing the entire household versus decolonizing the index case alone. METHODS An open-label, randomized trial enrolled 183 pediatric patients (cases) with community-onset S. aureus skin abscesses and colonization of anterior nares, axillae, or inguinal folds from 2008 to 2009 at primary and tertiary centers. Participants were randomized to decolonization of the case alone (index group) or of all household members (household group). The 5-day regimen included hygiene education, twice-daily intranasal mupirocin, and daily chlorhexidine body washes. Colonization of cases and subsequent skin and soft tissue infection (SSTI) in cases and household contacts were ascertained at 1, 3, 6, and 12 months. RESULTS Among 147 cases with 1-month colonization data, modified intention-to-treat analysis revealed S. aureus eradication in 50% of cases in the index group and 51% in the household group (P = 1.00). Among 126 cases completing 12-month follow-up, S. aureus was eradicated from 54% of the index group versus 66% of the household group (P = .28). Over 12 months, recurrent SSTI was reported in 72% of cases in the index group and 52% in the household group (P = .02). SSTI incidence in household contacts was significantly lower in the household versus index group during the first 6 months; this trend continued at 12 months. CONCLUSIONS Household decolonization was not more effective than individual decolonization in eradicating community-associated S. aureus carriage from cases. However, household decolonization reduced the incidence of subsequent SSTI in cases and their household contacts. CLINICAL TRIALS REGISTRATION NCT00731783.
منابع مشابه
Community Versus Nosocomial Staphylococcus aureus Septicemia in Children Admitted to Aliasghar Children Hospital, Tehran, Iran
Background and Objectives: The aim of the study was to determine the role and characteristics of nosocomial and community acquired Staphylococcus sepsis in admitted children in tertiary centers in Iran. Patients and Methods: A cross sectional descriptive-analytic study was performed since March 2008 to March 2009 in which all blood cultures from various admitted patients were checked for Sta...
متن کاملNasal Colonization Rate of Community and Hospital Acquired Methicillin Resistant Staphylococcus Aureus in Hospitalized Children
Background & Aims: Prevalence of community and hospital acquired methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing. The primary reservoir is the anterior nares; and nasal carriage is a risk factor for infection in a variety of populations. Infection due to hospital-acquired colonization is different from community acquired in clinical manifestations and antibiotics susc...
متن کاملبررسی تأثیر وانکومایسین موضعی درحذف استاف اورئوس در پولیپوز سینونازال بعد از جراحی آندوسکوپی سینوس
Introduction: One of the main theories in development of sinonasal polyposis involves the effect of Staphylococcus aureus super antigens and microbial biofilm. The aim of this study was to evaluate the effect of topical vancomycin on Staphylococcus aureus removal from sinus mucosa following surgery. Methods: In this randomized triple-blind clinical trial, 35 patients, who underwent sinus...
متن کاملRandomized Controlled Trial of Chlorhexidine Gluconate for Washing, Intranasal Mupirocin, plus Rifampin and Doxycycline versus No Treatment for the Eradication of Methicillin-Resistant Staphylococcus aureus (MRSA) Colonization
متن کامل
Methodologic considerations of household-level methicillin-resistant Staphylococcus aureus decolonization among persons living with HIV.
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 an...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
دوره 54 6 شماره
صفحات -
تاریخ انتشار 2012