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)

• Status: Completed
• Trial end date: 2011-09-01
• Target enrollment: 0
• Participant gender: All

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.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Harvard Pilgrim Health Care
• Collaborators: Agency for Healthcare Research and Quality (AHRQ); Centers for Disease Control and Prevention; Department of Population Medicine, Harvard Medical School / Harvard Pilgrim Healthcare Institute; Hospital Corporation of America; University of California, Irvine
• Treatments: Chlorhexidine; Chlorhexidine gluconate; Mupirocin

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.