Control of MRSA in Nursing Homes: Decolonization vs Standard Precautions

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01138462
Recruitment Status : Completed
First Posted : June 7, 2010
Last Update Posted : May 23, 2014
Information provided by (Responsible Party):
Bellini Cristina, University of Lausanne Hospitals

Brief Summary:
The purpose of this study is to determine the better approach between the currently procedure (i.e. standards precautions) and a reinforced strategy to control MRSA transmission in the institutionalized population of nursing homes in Canton of Vaud, Switzerland.

Condition or disease Intervention/treatment Phase
Methicillin-Resistant Staphylococcus Aureus Other: intervention Not Applicable

Detailed Description:
MRSA carriage among nursing homes residents of Canton Vaud, Switzerland, is increasing, despite use of standard precautions. Recommendation to prevent MRSA transmission in long term care facilities are lacking. We aim to reinforce the current infection control strategy by general MRSA screening of institutionalised residents and decolonisation of MRSA carriers. Because the uncertainties in the impact of this reinforced strategy, we aim to compare this action to the policy actually applied.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 157 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Universal Screening and Decolonization vs Standard Precautions for Control of Methicillin-resistant Staphylococcus Aureus (MRSA) in Nursing Homes: a Cluster, Randomised Controlled Study.
Study Start Date : June 2010
Actual Primary Completion Date : December 2011
Actual Study Completion Date : December 2011

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
No Intervention: Standard Precautions
control arm, standards precautions for all residents living in the nursing home of control arm, including MRSA carriers
Intervention arm, standards precautions for all residents living in nursing homes of intervention arm, and topical decolonization for MRSA carriers, including environmental disinfection
Other: intervention

5 days topical decolonisation including nasal mupirocin tid, chlorhexidine mouth wash tid, chlorhexidine body wash once daily.

Daily direct resident's environmental disinfection during decolonisation.

Other Name: topical MRSA decolonisation and environmental disinfection

Primary Outcome Measures :
  1. To determine the change in prevalence of MRSA carriage among residents of each Nursing homes group at the end of the one study year [ Time Frame: 1 year ]
    in each control and intervention nursing home: MRSA screening of all residents of nursing homes of Canton Vaud, at baseline and 1 year later, in order to compare MRSA prevalence changes at nursing homes levels

Secondary Outcome Measures :
  1. To determine the effectiveness of the reinforced strategy to prevent MRSA infection, compared to the standard strategy [ Time Frame: 1 year ]
    In a subpopulation of all nursing homes residents (10% of the whole population), recording of all microbiologically documented MRSA infection, according to nosocomial infection definitions of the Center of Diseases Control (CDC) of Atlanta.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • all nursing homes of canton Vaud, Switzerland, that give the consent of participation

Exclusion Criteria:

- refusal to participate

Inclusion criteria for decolonisation in intervention nursing homes:

- all MRSA positive residents living in a Nursing Home included in the intervention group

Exclusion Criteria for decolonisation:

  • residents that refuse to be screened or refused the decolonisation
  • life expectancy shorter of 7 days
  • known intolerance of disinfectant/ topical antibiotics used in the protocol
  • active MRSA infection
  • asymptomatic MRSA bacteriuria
  • stage IV wound (according to National Pressure Ulcer Advisory Panel)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01138462

all nursing homes of canton Vaud
Canton de Vaud, Canton Vaud, Switzerland
Sponsors and Collaborators
University of Lausanne Hospitals
Study Director: Giorgio Zanetti, MD University Hospital of Lausanne, Switzerland

Responsible Party: Bellini Cristina, MD, University of Lausanne Hospitals Identifier: NCT01138462     History of Changes
Other Study ID Numbers: Protocole 96/10
First Posted: June 7, 2010    Key Record Dates
Last Update Posted: May 23, 2014
Last Verified: May 2014

Keywords provided by Bellini Cristina, University of Lausanne Hospitals:
Methicillin-Resistant Staphylococcus aureus
Nursing homes
Infection Control

Additional relevant MeSH terms:
Staphylococcal Infections
Gram-Positive Bacterial Infections
Bacterial Infections
Anti-Bacterial Agents
Anti-Infective Agents