Human Microbiome and Healthcare Associated Infections - Nursing Home Dwelling Older Veterans

Study Overview
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Brief Summary
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The purpose of the research is to find out the effect of commonly used topical antibiotics on the bacteria that live in the nose, throat and on the skin of older adults. In addition, the investigators want to determine if these topical antibiotics affect how bacteria are spread in Community Living Centers of the VA Maryland Health Care System.

Official Title
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Human Microbiome and Healthcare Associated Infections - Nursing Home Dwelling Older Veterans

Conditions
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Human Microbiome

Intervention / Treatment
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* Drug: Intranasal Mupirocin and Topical Chlorhexidine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 50 years or older. Living in a participating nursing home for at least 80% of the past 3 months- Willing to provide anterior nares, posterior pharynx, skin and throat specimens over the study period. Willing to use intranasal mupirocin and topical chlorhexidine over a five day period. Provide signed and dated informed consent from subject or LAR. Exclusion Criteria: Recent history of MRSA colonization Use of mupirocin nasal ointment in past 3 months Use of topical chlorhexidine in past 3 months History of an allergic reaction to chlorhexidine or mupirocin

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intranasal Mupirocin and Topical Chlorhexidine<br> | Drug: Intranasal Mupirocin and Topical Chlorhexidine<br>* Antimicrobial antiseptic skin cleanser (4% chlorhexidine) for daily use on Day 1, 3 and 5 of Week 8 of the study. BACTROBAN NASAL ointment (mupirocin calcium ointment, 2%) for use intranasally twice-daily on Day 1, 2, 3, 4 and 5 of Week 8 of the study.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the Abundance of Staphylococcus Aureus in the Nose After Decolonization | Change in the abundance of Staphylococcus aureus in the nose from immediately before mupirocin administration to 8 weeks after mupirocin administration. | 8 weeks | 
| Change in the Abundance of Staphylococcus Aureus in the Throat After Decolonization | Change in the abundance of Staphylococcus aureus in the throat from immediately before mupirocin administration to 8 weeks after mupirocin administration. | 8 weeks | 
| Change in the Abundance of Gram Negative Bacteria on the Subclavian Skin After Decolonization | Quantitative PCR using 16s rRNA is used to quantify the total bacterial load of Gram negative bacteria on the subclavian skin before and after decolonization. | 12 months | 
| Change in the Abundance of Gram Negative Bacteria on the Femoral Skin After Decolonization | Quantitative PCR using 16s rRNA is used to quantify the total bacterial load of Gram negative bacteria on the femoral skin before and after decolonization. | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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intranasal mupirocin, topical chlorhexidine