Please select the eligibility criteria that correspond to the clinical trial below.
Title: Cluster Randomized Trial of Hospitals to Assess Impact of Targeted Versus Universal
Brief Summary: The Randomized Evaluation of Decolonization versus Universal Clearance to Eliminate MRSA (REDUCE MRSA) Trial is a cluster randomized trial of the comparative effectiveness of three strategies to prevent methicillin-resistant Staphylococcus aureus (MRSA) in intensive care units. The three strategies to be evaluated are:

* screening on admission followed by isolation of MRSA+ patients
* screening on admission followed by isolation and decolonization of MRSA+ patients
* universal decolonization on admission with no screening. The decolonization regimen involves bathing with chlorhexidine plus intra-nasal application of mupirocin. The main outcome will be MRSA+ clinical cultures.

The study is a partnership between the CDC, the CDC Prevention Epicenters, and the Hospital Corporation of America.


Options:
A: Inclusion Criteria:

* colonization with either MRSA, VRE or ESBL is endemic
* at least one dedicated infection control physician
* ability to obtain, store and analyze surveillance cultures
* at least 8 ICU beds; all of which have possibility for mechanical ventilation
* ability to collect the data required for analysis
* written approval of the institution's IRB
* signed protocol signature page

Exclusion Criteria:

* burn units
* cardiothoracic units
* pediatric and neonatal ICUs
* ICU is currently using rapid diagnostic testing in their screening program for AMRB
* ICU is planning to enroll subjects in studies testing investigational agents for the purpose of eradicating or preventing colonization with MRSA, VRE or ESBL or devices or practice management strategies that have colonization and/or infection with AMRB as an outcome
* using SOD/ SDD or any topical antimicrobial therapy
* using chlorhexidine body washings
B: Inclusion Criteria:

* Inclusion criteria will include all HCA hospitals that reside in US states where physicians do NOT routinely prescribe decolonization for MRSA + ICU patients.

Exclusion Criteria:

* Exclusion criteria will include hospitals where ICU physicians often prescribe decolonization for MRSA+ ICU patients.
* Dedicated burn ICUs will also be excluded due to the inability to perform routine bathing.
* Finally, since the intent is to assess the intervention in adult ICUs, pediatric hospitals will be excluded although patients \<13 years old that are admitted to participating adult ICUs will be included in the unit-based intervention.
C: Inclusion Criteria:

* Data collection will be compiled from all the participants admitted to the Medical Intensive Care Unit (MICU).
* For skin cultures: One randomly selected (intubated or non-intubated) patient in each intervention group

Exclusion Criteria:

* Patients with greater than 20% of body surface area disruption in skin integrity will be excluded from participation in the 2% CHG Antiseptic Cloths arm of the study
D: Inclusion Criteria:

* Age \> 18 years
* Admission in critical care unit eg. ICU, respiratory care unit, Cardiac care unit with in 24 hours
* Expected duration of critical care unit admission \> 48 hours

Exclusion Criteria:

* History of chlorhexidine allergy

Answer: B