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- Title
Comparative Effectiveness Study of Home-Based Interventions to Prevent CA-MRSA Infection Recurrence.
- Authors
Tobin, Jonathan N.; Hower, Suzanne; D'Orazio, Brianna M.; Pardos de la Gándara, María; Evering, Teresa H.; Khalida, Chamanara; Ramachandran, Jessica; González, Leidy Johana; Kost, Rhonda G.; Vasquez, Kimberly S.; de Lencastre, Hermínia; Tomasz, Alexander; Coller, Barry S.; Vaughan, Roger
- Abstract
Recurrent skin and soft tissue infections (SSTI) caused by Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) or Methicillin-Sensitive Staphylococcus aureus (CA-MSSA) present treatment challenges. This community-based trial examined the effectiveness of an evidence-based intervention (CDC Guidelines, topical decolonization, surface decontamination) to reduce SSTI recurrence, mitigate household contamination/transmission, and improve patient-reported outcomes. Participants (n = 186) were individuals with confirmed MRSA(+)/MSSA(+) SSTIs and their household members. During home visits; Community Health Workers/Promotoras provided hygiene instructions; a five-day supply of nasal mupirocin; chlorhexidine for body cleansing; and household disinfecting wipes (Experimental; EXP) or Usual Care Control (UC CON) pamphlets. Primary outcome was six-month SSTI recurrence from electronic health records (EHR). Home visits (months 0; 3) and telephone assessments (months 0; 1; 6) collected self-report data. Index patients and participating household members provided surveillance culture swabs. Secondary outcomes included household surface contamination; household member colonization and transmission; quality of life; and satisfaction with care. There were no significant differences in SSTI recurrence between EXP and UC in the intent-to-treat cohort (n = 186) or the enrolled cohort (n = 119). EXP participants showed reduced but non-significant colonization rates. EXP and UC did not differ in household member transmission, contaminated surfaces, or patient-reported outcomes. This intervention did not reduce clinician-reported MRSA/MSSA SSTI recurrence. Taken together with other recent studies that employed more intensive decolonization protocols, it is possible that a promotora-delivered intervention instructing treatment for a longer or repetitive duration may be effective and should be examined by future studies.
- Subjects
CENTERS for Disease Control &; Prevention (U.S.); DISEASE relapse; SOFT tissue infections; COLONIZATION (Ecology); METHICILLIN-resistant staphylococcus aureus; QUALITY of life
- Publication
Antibiotics (2079-6382), 2021, Vol 10, Issue 9, p1105
- ISSN
2079-6382
- Publication type
Article
- DOI
10.3390/antibiotics10091105