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

TitreUniversal screening and decolonization for control of MRSA in nursing homes : a cluster randomized controlled study
Publication TypeJournal Article
Year of Publication2015
AuthorsBellini, C, Petignat, C, Masserey, E, Büla, C, Burnand, B, Rousson, V, Blanc, DS, Zanetti, G
JournalInfection Control & Hospital Epidemiology
Date Published04/2015
ISBN Number0899-823X

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



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Alternate JournalInfect Control Hosp Epidemiol
Citation Key / SERVAL IDserval:BIB_2C1DB359EAE2
Peer reviewRefereed
PubMed ID25782894


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