Effectiveness of measures to eradicate Staphylococcus aureus carriage in patients with community-associated skin and soft-tissue infections: a randomized trial.
Effectiveness of measures to eradicate Staphylococcus aureus carriage in patients with community-associated skin and soft-tissue infections: a randomized trial.
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DOI：
10.1086/661285
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发表时间：
2011-09
影响因子：
4.5
通讯作者：
Storch GA
中科院分区：
文献类型：
--
作者：
Fritz SA;Camins BC;Eisenstein KA;Fritz JM;Epplin EK;Burnham CA;Dukes J;Storch GA
尽管缺乏证据，但对复发性金黄色葡萄球菌皮肤和软组织感染（SSTI）的门诊患者规定了去殖民化措施。比较四种方案根除沙门氏菌的效果。金黄色马车。开放标签、随机对照试验。在一个月和四个月时确定了定植状态和复发性SSTI。巴恩斯犹太人和圣路易斯儿童医院，圣路易斯，密苏里州，2007-2009年。300例社区发病的SSTI和S。金黄色葡萄球菌在鼻孔、腋窝或腹股沟皱褶中定植。参与者被随机分配至不接受治疗干预（对照组）或进行三种为期5天的方案之一：2%莫匹罗星软膏每日两次应用于鼻孔，鼻内莫匹罗星加每日4%氯己定沐浴液，或鼻内莫匹罗星加每日稀释漂白水浴。在244名有一个月定植数据的参与者中，改良的意向治疗分析显示S。仅教育（对照）组中38%的参与者的金黄色葡萄球菌根除率;莫匹罗星组中56%（p=0.03 vs.对照）;莫匹罗星/氯己定组中55%（p=0.05）;莫匹罗星/漂白剂组中63%（p=0.006）。在229名有4个月定植数据的参与者中，对照组的根除率为48%;仅莫匹罗星为56%（p=0.40 vs.对照组）;莫匹罗星/氯己定为54%（p=0.51）;莫匹罗星/漂白剂为71%（p=0.02）。在一个月和四个月时，分别有20%和36%的参与者报告复发性SSTI。一个廉价的方案，稀释漂白浴，鼻内莫匹罗星，和卫生教育有效地根除了S。金黄色葡萄球菌超过四个月。SSTI的高复发率表明内源性定植以外的因素是感染的重要决定因素。
Despite a paucity of evidence, decolonization measures are prescribed for outpatients with recurrent Staphylococcus aureus skin and soft tissue infections (SSTI). Compare the effectiveness of four regimens for eradicating S. aureus carriage. Open-label, randomized controlled trial. Colonization status and recurrent SSTI were ascertained at one and four months. Barnes-Jewish and St. Louis Children’s Hospitals, St. Louis, Missouri, 2007–2009. Three hundred patients with community-onset SSTI and S. aureus colonization in the nares, axilla, or inguinal folds. Participants were randomized to receive no therapeutic intervention (controls) or perform one of three 5-day regimens: 2% mupirocin ointment applied to the nares twice daily, intranasal mupirocin plus daily 4% chlorhexidine body washes, or intranasal mupirocin plus daily dilute bleach water baths. Among 244 participants with one-month colonization data, modified intention-to-treat analysis revealed S. aureus eradication in 38% of participants in the education only (control) group; 56% in the mupirocin group (p=0.03 vs. controls); 55% in the mupirocin/chlorhexidine group (p=0.05); and 63% in the mupirocin/bleach group (p=0.006). Of 229 participants with four-month colonization data, eradication rates were 48% in controls; 56% for mupirocin only (p=0.40 vs. controls); 54% for mupirocin/chlorhexidine (p=0.51); and 71% for mupirocin/bleach (p=0.02). At one and four months, respectively, recurrent SSTI was reported by 20% and 36% of participants. An inexpensive regimen of dilute bleach baths, intranasal mupirocin, and hygiene education effectively eradicated S. aureus over four months. High rates of recurrent SSTI suggest factors other than endogenous colonization as important determinants of infection.
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影响因子：
28.2
作者：
Fritz, Stephanie A.;Epplin, Emma K.;Storch, Gregory A.
通讯作者：
Storch, Gregory A.
影响因子：
--
作者：
Hersh, Adam L.;Chambers, Henry F.;Gonzales, Ralph
通讯作者：
Gonzales, Ralph
影响因子：
8
作者：
Fritz, Stephanie A.;Garbutt, Jane;Storch, Gregory A.
通讯作者：
Storch, Gregory A.
影响因子：
11.8
作者：
Liu, Catherine;Bayer, Arnold;Chambers, Henry F.
通讯作者：
Chambers, Henry F.
DOI：
10.1097/00004630-199109000-00005
发表时间：
1991-01-01
期刊：
Journal of Burn Care and Rehabilitation
影响因子：
--
作者：
HEGGERS J P;SAZY J A;ROBSON M C
通讯作者：
ROBSON M C