Conditions: Staphylococcal Infections
Keywords: Methicillin resistance Infection control Staphylococcus aureus Cross infection Epidemiology Chlorhexidine
Allocation: NON_RANDOMIZED | Intervention model: PARALLEL
Enrollment: 1518
Healthy volunteers: no

Brief summary:
This pilot study in our medical intensive care unit will evaluate the clinical and cost-effectiveness of an active surveillance program for methicillin-resistant Staphylococcus aureus (MRSA), compared to routine daily bathing with chlorhexidine gluconate (CHG)-impregnated cloths. Outcomes include rate of MRSA acquisition, and of other hospital-acquired infections (e.g., catheter-associated bloodstream infections).

Detailed description:

Arms:
arm 1: Active surveillance cultures (ASC) (via nasal swabs) will be performed for all patients admitted to the medical intensive care unit (ICU) during the designated study period. All patients will be placed in contact isolation until nasal swabs return negative; otherwise will remain in isolation. arm 2: Chlorhexidine gluconate (CHG) cloths will be used to bathe patients daily instead of standard soap and water. Active surveillance cultures (ASC) will also be used in this arm, but results will be blinded and not used to determine whether patients should be in contact isolation.

Interventions: intervention 1: Nasal swabs for MRSA culture intervention 2: Chlorhexidine gluconate intervention 3: Contact isolation
Intervention descriptions: intervention 1: Patients will have nasal swabs performed upon ICU admission, upon discharge, and every 2 weeks while they remain in the ICU. intervention 2: CHG-impregnated cloths (2%) will be used to bathe patients at least daily during the duration of their medical ICU stay. Surveillance cultures will be obtained on admission, discharge and every 2 weeks while in the ICU, but results will be blinded until conclusion of the study. intervention 3: All patients will be placed in contact isolation until the results of their active surveillance cultures are negative; if positive, they will remain in isolation.

Protocol document: