N/A
N=43
Cluster Randomized Trial of Hospitals to Assess Impact of Targeted Versus Universal Strategies to Reduce Methicillin-resistant Staphylococcus Aureus (MRSA) in Intensive Care Units (ICUs)
Methicillin-resistant Staphylococcus Aureus
Bottom Line
View on ClinicalTrials.gov: NCT00980980 ↗Enrolled (actual)
43
Serious AEs
0.0%
Results posted
Jul 2014
Primary outcome: Primary: Main Outcome: Patients With Nosocomial MRSA Clinical Cultures — 0.92; 0.75; 0.63 hazard ratio — p=0.01
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Chlorhexidine bath and nasal mupirocin (Drug)
- Age
- Pediatric, Adult, Older Adult · 13+ yrs
- Sex
- All
- Sponsor
- Harvard Pilgrim Health Care
- Primary completion
- Sep 2011
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Main Outcome: Patients With Nosocomial MRSA Clinical Cultures |
0.92; 0.75; 0.63 | 0.01 sig |
| SECONDARY MRSA Bloodstream Infection |
1.23; 1.23; 0.72 | — |
| SECONDARY ICU-attributable All-pathogen Bloodstream Infection |
0.99; 0.78; 0.56 | — |
| SECONDARY Intervention Impact on Healthcare Costs |
9,120; 9,120; 0; 69,010; 68,830; 24,890 | — |
| SECONDARY Blood Culture Contamination Rates |
0.74; 0.94; 0.56; 0.73; 0.93; 0.55 | — |
| SECONDARY Intervention Impact on Bacteriuria and Candiduria |
1.02; 0.88; 0.87; 0.97; 0.83; 0.93 | — |
| SECONDARY Intervention Impact on Mupirocin Susceptibility of MRSA Isolates |
1.0; 1.4; 0.5; 0.8; 0.9; 0.7 | — |
| SECONDARY Intervention Impact on Chlorhexidine Susceptibility of MRSA Isolates |
2; 0; 0 | — |
Summary
The Randomized Evaluation of Decolonization versus Universal Clearance to Eliminate MRSA (REDUCE MRSA) Trial is a cluster randomized trial of the comparative effectiveness of three strategies to prevent methicillin-resistant Staphylococcus aureus (MRSA) in intensive care units. The three strategies to be evaluated are:
* screening on admission followed by isolation of MRSA+ patients
* screening on admission followed by isolation and decolonization of MRSA+ patients
* universal decolonization on admission with no screening. The decolonization regimen involves bathing with chlorhexidine plus intra-nasal application of mupirocin. The main outcome will be MRSA+ clinical cultures.
The study is a partnership between the CDC, the CDC Prevention Epicenters, and the Hospital Corporation of America.
Eligibility Criteria
Inclusion Criteria
- Inclusion criteria will include all HCA hospitals that reside in US states where physicians do NOT routinely prescribe decolonization for MRSA + ICU patients.
Exclusion Criteria
- Exclusion criteria will include hospitals where ICU physicians often prescribe decolonization for MRSA+ ICU patients.
- Dedicated burn ICUs will also be excluded due to the inability to perform routine bathing.
- Finally, since the intent is to assess the intervention in adult ICUs, pediatric hospitals will be excluded although patients <13 years old that are admitted to participating adult ICUs will be included in the unit-based intervention.
Data sourced from ClinicalTrials.gov (NCT00980980). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.