Cultures Before and After Decolonization in Community Dwelling Adults With Current S. Aureus Colonization
Condition: Human Microbiome
Intervention: Mupirocin calcium ointment, 2%; Topical Chlorhexidine, 4%
Intervention description: Mupirocin nasal ointment is used to treat or prevent infections in the nose due to certain strains of Staphylococcus aureus bacteria. This medicine works by killing bacteria or preventing their growth.; Chlorhexidine is an antiseptic that fights bacteria.
Topical chlorhexidine is used to clean the skin to prevent infection that may be caused by surgery, injection, or skin injury.
Intervention MeSH terms: Chlorhexidine; Mupirocin; Calcium
Phase: Phase 4
Study type: Interventional
Primary purpose: Health Services Research
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 58.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: intranasal mupirocin; topical chlorhexidine

Summary:

      The investigators propose to study the microbiome of the nose, throat and three skin sites in
      a population without current exposure to the healthcare environment: 80 community dwelling
      adults. We will characterize the microbial communities in these body sites (nose, throat,
      perirectal and three skin sites) over time using culture-independent techniques. The
      investigators will then "decolonize" the subjects. Subjects will receive intranasal mupirocin
      and topical chlorhexidine. The investigators will then compare the microbial communities at
      baseline and after decolonization within individuals. Our overall hypothesis is that the
      microbial composition of these sites and the response to decolonization is influenced by the
      healthcare environment and that decolonization leads to re-colonization with an increasing
      proportion of Gram-negative bacilli.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Veteran living in the greater Baltimore, MD area

          -  Adults >= 18 years of age

          -  Living independently

          -  Willing and able to provide anterior nares, skin, throat, and perirectal specimens
             over an 18 week time period.

          -  Willing and able to administer intranasal mupirocin and topical chlorhexidine over a
             five day period

          -  Capable of understanding and complying with the entire study protocol.

          -  Provided signed and dated informed consent

        Exclusion Criteria:

          -  Use of anticancer chemotherapy or radiation therapy (cytotoxic) within the past 6
             months

          -  History of HIV infection with most recent CD4 of <200

          -  Immunosuppression medications within the past 3 months

          -  Use of systemic antibacterial or antifungal agents in the past 3 months

          -  Use of nasal steroids currently or in the past 3 months

          -  Use of nasal antimicrobial ointment in the past 3 months

          -  Any current indwelling percutaneous medical device or urinary catheter

          -  Acute care hospitalization in the past 3 months

          -  Planned surgery or hospitalization during the study period

          -  History of an allergic reaction to chlorhexidine or mupirocin

          -  Oral temperature of >100 F at enrollment visit

          -  BMI <18 or >35 at enrollment visit