Universal screening and decolonization for control of MRSA in nursing homes : a cluster randomized controlled study

Details

Ressource 1Download: serval:BIB_2C1DB359EAE2.P001 (201.53 [Ko])
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It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_2C1DB359EAE2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Universal screening and decolonization for control of MRSA in nursing homes : a cluster randomized controlled study
Journal
Infection Control & Hospital Epidemiology
Author(s)
Bellini C., Petignat C., Masserey E., Büla C., Burnand B., Rousson V., Blanc DS., Zanetti G.
ISSN
0899-823X
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
36
Number
4
Pages
401-408
Language
english
Notes
IUMSP2015/04
Abstract
OBJECTIVE The risk of carrying methicillin-resistant Staphylococcus aureus (MRSA) is higher among nursing home (NH) residents than in the general population. However, control strategies are not clearly defined in this setting. In this study, we compared the impact of standard precautions either alone (control) or combined with screening of residents and decolonization of carriers (intervention) to control MRSA in NHs. DESIGN Cluster randomized controlled trial SETTING NHs of the state of Vaud, Switzerland PARTICIPANTS Of 157 total NHs in Vaud, 104 (67%) participated in the study. INTERVENTION Standard precautions were enforced in all participating NHs, and residents underwent MRSA screening at baseline and 12 months thereafter. All carriers identified in intervention NHs, either at study entry or among newly admitted residents, underwent topical decolonization combined with environmental disinfection, except in cases of MRSA infection, MRSA bacteriuria, or deep skin ulcers. RESULTS NHs were randomly allocated to a control group (51 NHs, 2,412 residents) or an intervention group (53 NHs, 2,338 residents). Characteristics of NHs and residents were similar in both groups. The mean screening rates were 86% (range, 27%-100%) in control NHs and 87% (20%-100%) in intervention NHs. Prevalence of MRSA carriage averaged 8.9% in both control NHs (range, 0%-43%) and intervention NHs (range, 0%-38%) at baseline, and this rate significantly declined to 6.6% in control NHs and to 5.8% in intervention NHs after 12 months. However, the decline did not differ between groups (P=.66). CONCLUSION Universal screening followed by decolonization of carriers did not significantly reduce the prevalence of the MRSA carriage rate at 1 year compared with standard precautions
Pubmed
Web of science
Open Access
Yes
Create date
26/01/2015 14:44
Last modification date
25/09/2019 6:08
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