RecruitingACTRN12607000322437

Do rapid detection & isolation of colonised patients reduce Methicillin-Resistant Staphylococcus Aureus (MRSA) spread? An epidemiological, economic & modelling study.

Does rapid detection and isolation with use of contact precautions for MRSA colonised intensive care unit patients result in decreased transmission of MRSA compared with no active screening and use of standard precautions?


Sponsor

Caroline Marshall

Enrollment

3,000 participants

Start Date

May 21, 2007

Study Type

Interventional

Conditions

Summary

MRSA is a significant problem for hospital patients, causing increased length of stay and risk of complications. It is spread mainly on the contaminated hands of healthcare workers. Control of MRSA within hospitals still remains controversial, with some insisting that swabbing of all patients and use of special isolation precautions is mandatory for prevention of its spread. We plan to test whether swabbing all patients admitted to the intensive care unit and then putting patients who are found to be positive in single rooms and using gloves and gowns for all contact with these patients is more effective at preventing spread of MRSA from patient to patient than what we currently do ie looking after patients in the general ward, wearing plastic aprons at all times and only using gowns and gloves if we are likely to come into contact with bodily fluids (and not swabbing any patients). We plan to use the most rapid tests available to determine whether someone is carrying MRSA on their body which will give us a result within hours compared with the 2-3 days it currently takes to get a result. We also plan to do an economic evaluation to see if the intervention is worth the extra cost.


Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Inclusion Criteria1

  • All patients admitted to the Royal Melbourne Hospital (adult) ICU

Exclusion Criteria1

  • Nil

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Interventions

Intervention group: All patients admitted to the ICU during this time period will undergo active screening with rapid molecular detection of MRSA on admission to, discharge from and twice weekly durin

Intervention group: All patients admitted to the ICU during this time period will undergo active screening with rapid molecular detection of MRSA on admission to, discharge from and twice weekly during the ICU stay. Patients found to be colonised with MRSA will be isolated in a single room (or cohorted with other MRSA colonised patients). Contact precautions (gloves and gowns for all contacts) will also be used for MRSA colonised patients. These precautions will be used for the duration of the patient's ICU stay once found to be colonised. Patients not found to be colonised will be managed using the same infection control precautions as in the control period (ie standard precautions and plastic aprons for all patients).


Locations(1)

Australia

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ACTRN12607000322437