Study: MRSA Infection Risk Greatly Reduced By Home Decolonization

The results of a new study indicate that decolonization efforts at home can significantly reduce the likelihood of infection for hospitalized patients harboring methicillin-resistant Staphylococcus aureus (MRSA).

A trial — called "Changing Lives by Eradicating Antibiotic Resistance (CLEAR) — randomly divided more than 2,100 adult hospital patients with colonized MRSA into one of two groups. One group received post-discharge hygiene education. The other received this education plus a decolonization protocol. Decolonization involved the use of chlorhexidine mouthwash; baths or showers with chlorhexidine; and nasal mupirocin by patients for five days repeated twice per month over six months. Participants were followed for 12 months following discharge.

Among the findings of the study, which was published in the New England Journal of Medicine: The decolonization group experienced 30% fewer MRSA infections and 17% fewer infections of any kind. Decolonization group patients who fully adhered to the regimen (i.e., did not miss any decolonization doses) experienced 44% fewer MRSA infections and 40% fewer infections overall.

As a press release noted, the Centers for Disease Control and Prevention (CDC) has shown that MRSA carriers discharged from hospitals are at high risk of serious disease from MRSA in the year following their discharge. Approximately 5-10% of hospitalized patients are MRSA carriers.

In the release, Dr. Mary Hayden, professor of internal medicine and pathology, chief of the division of infectious diseases and director of the division of clinical microbiology at Rush University Medical Center, said, "Our goal was to understand whether removing MRSA from the skin, nose and throat was better than hygiene education alone in reducing MRSA or other infections and associated hospitalizations. … With an issue this large, we wanted to find best practice strategies to prevent these infections and associated hospitalizations. This large clinical trial helped determine that there is a way to help prevent infections after patients go home and it can prevent readmission."