Susan E Kline1, James D Neaton2, Ruth Lynfield3, Patricia Ferrieri4, Shalini Kulasingam5, Kayleigh Dittes1, Anita Glennen3, Selina Jawahir3, Alexander Kaizer6, Jeremiah Menk6, James R Johnson1. 1. 1University of Minnesota Medical School,Department of Medicine,Division of Infectious Diseases,Minneapolis,Minnesota. 2. 2Division of Biostatistics,University of Minnesota School of Public Health,Minneapolis,Minnesota. 3. 3Minnesota Department of Health,St Paul,Minnesota. 4. 4Department of Laboratory Medicine and Pathology,University of Minnesota Medical School,Minneapolis,Minnesota. 5. 5Division of Epidemiology,University of Minnesota School of Public Health,Minneapolis,Minnesota. 6. 6Biostatistical Design and Analysis Center,University of Minnesota,Minneapolis,Minnesota.
Abstract
OBJECTIVE: To 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. DESIGN: Open label, single-center, randomized clinical trial. SETTING:Ambulatory 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. METHODS:Consenting 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. RESULTS: Of 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%; P<.0001). CONCLUSION: An 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.
RCT Entities:
OBJECTIVE: To 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. DESIGN: Open label, single-center, randomized clinical trial. SETTING: Ambulatory 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. METHODS: Consenting 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. RESULTS: Of 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%; P<.0001). CONCLUSION: An 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.
Authors: Paula Zwicker; Johannes Schleusener; Silke B Lohan; Loris Busch; Claudia Sicher; Sven Einfeldt; Michael Kneissl; Anja A Kühl; Cornelia M Keck; Christian Witzel; Axel Kramer; Martina C Meinke Journal: Sci Rep Date: 2022-02-16 Impact factor: 4.379
Authors: Nusaiba F Baker; Owen Brown; Alexandra M Hart; Dora Danko; Christopher M Stewart; Peter W Thompson Journal: Plast Reconstr Surg Glob Open Date: 2022-03-22
Authors: Sarah M Bartsch; Kim F Wong; Leslie E Mueller; Gabrielle M Gussin; James A McKinnell; Thomas Tjoa; Patrick T Wedlock; Jiayi He; Justin Chang; Shruti K Gohil; Loren G Miller; Susan S Huang; Bruce Y Lee Journal: JAMA Netw Open Date: 2021-08-02