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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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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 |
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author | Short, Christopher T. Mietchen, Matthew S. Lofgren, Eric T. |
author_facet | Short, Christopher T. Mietchen, Matthew S. Lofgren, Eric T. |
author_sort | Short, Christopher T. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7084547 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-70845472020-03-24 Assessing the Potential Impact of a Long-Acting Skin Disinfectant in the Prevention of Methicillin-Resistant Staphylococcus aureus Transmission Short, Christopher T. Mietchen, Matthew S. Lofgren, Eric T. Int J Environ Res Public Health Article 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. MDPI 2020-02-26 2020-03 /pmc/articles/PMC7084547/ /pubmed/32110949 http://dx.doi.org/10.3390/ijerph17051500 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Short, Christopher T. Mietchen, Matthew S. Lofgren, Eric T. Assessing the Potential Impact of a Long-Acting Skin Disinfectant in the Prevention of Methicillin-Resistant Staphylococcus aureus Transmission |
title | Assessing the Potential Impact of a Long-Acting Skin Disinfectant in the Prevention of Methicillin-Resistant Staphylococcus aureus Transmission |
title_full | Assessing the Potential Impact of a Long-Acting Skin Disinfectant in the Prevention of Methicillin-Resistant Staphylococcus aureus Transmission |
title_fullStr | Assessing the Potential Impact of a Long-Acting Skin Disinfectant in the Prevention of Methicillin-Resistant Staphylococcus aureus Transmission |
title_full_unstemmed | Assessing the Potential Impact of a Long-Acting Skin Disinfectant in the Prevention of Methicillin-Resistant Staphylococcus aureus Transmission |
title_short | Assessing the Potential Impact of a Long-Acting Skin Disinfectant in the Prevention of Methicillin-Resistant Staphylococcus aureus Transmission |
title_sort | assessing the potential impact of a long-acting skin disinfectant in the prevention of methicillin-resistant staphylococcus aureus transmission |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084547/ https://www.ncbi.nlm.nih.gov/pubmed/32110949 http://dx.doi.org/10.3390/ijerph17051500 |
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