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Assessing the Potential Impact of a Long-Acting Skin Disinfectant in the Prevention of Methicillin-Resistant Staphylococcus aureus Transmission

Healthcare-associated transmission of methicillin-resistant Staphylococcus aureus (MRSA) remains a persistent problem. The use of chlorhexidine gluconate (CHG) as a means of decolonizing patients, either through targeted decolonization or daily bathing, is frequently used to supplement other interve...

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Detalles Bibliográficos
Autores principales: Short, Christopher T., Mietchen, Matthew S., Lofgren, Eric T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084547/
https://www.ncbi.nlm.nih.gov/pubmed/32110949
http://dx.doi.org/10.3390/ijerph17051500
Descripción
Sumario:Healthcare-associated transmission of methicillin-resistant Staphylococcus aureus (MRSA) remains a persistent problem. The use of chlorhexidine gluconate (CHG) as a means of decolonizing patients, either through targeted decolonization or daily bathing, is frequently used to supplement other interventions. We explore the potential of a long-acting disinfectant with a persistent effect, immediate decolonizing action in the prevention of MRSA acquisition, and clinical illness and mortality in an 18-bed intensive care unit, based on a previous model. A scenario with no intervention is compared to CHG bathing, which decolonizes patients but provides no additional protection, and a hypothetical treatment that both decolonizes them and provides protection from subsequent colonization. The duration and effectiveness of this protection is varied to fully explore the potential utility of such a treatment. Increasing the effectiveness of the decolonizing agent reduces colonization, with a 10% increase resulting in a colonization rate ratio (RR) of 0.89 (95% CI: 0.89,0.90). Increasing the duration of protection results in a much more modest reduction, with a 12-hour increase in protection resulting in an RR of 0.99 (95% CI: 0.99, 0.99). There is little evidence of synergy between the two.