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Study of 2% Chlorhexidine Gluconate-Impregnated Bath Cloths to Prevent MRSA Colonization in Complex Continuing Care

Information source: Baycrest
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Staph Aureus Methicillin Resistant Colonization

Intervention: CHG antiseptic body cleanser (Drug)

Phase: Phase 4

Status: Completed

Sponsored by: Baycrest

Official(s) and/or principal investigator(s):
Chingiz Amirov, MPH, CIC, Principal Investigator, Affiliation: Baycrest

Summary

The purpose of this study is to determine whether daily bathing with 2% chlorhexidine gluconate-impregnated antiseptic cleanser (CHG) significantly reduces incidence of colonization of hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA). Investigators postulate that daily bathing with CHG significantly reduces incidence of colonization of hospitalized patients with MRSA.

Clinical Details

Official title: Randomized Controlled Clinical Trial of 2% Chlorhexidine Gluconate-Impregnated Bath Cloths to Prevent MRSA Colonization on Complex Continuing Care Units of Baycrest Hospital

Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention

Primary outcome: Incidence of MRSA colonization

Secondary outcome: Time to MRSA conversion

Detailed description: Bathing patients with 2% chlorhexidine gluconate-impregnated cloths (CHG) is an established practice at Baycrest. Our previous studies have demonstrated strong MRSA-preventive

properties of CHG bathing practice - the rate of MRSA transmission on intervention units

dropped from 4. 99 to 0. 88 cases per 1,000 patient days - an overall rate reduction of 82%.

Although CHG will continue to be used as part of an established clinical practice in our hospital, its impact on MRSA prevention merits further evaluation in complex continuing care (CCC) settings endemic for MRSA. Investigators propose a cluster-randomized, prospective, open-label, two-arm clinical trial (RCT) on three geographically separate, but otherwise

comparable, CCC units - one intervention unit using CHG, and two control units using

non-antiseptic cleanser. The RCT is expected to conclusively answer whether daily bathing with CHG significantly reduces incidence of MRSA colonization. By cluster randomization investigators imply randomly assigning interventions to the three patient care units. Investigators propose randomization of the units as it is not feasible to randomly assign the individual participants to intervention vs control arms. For a meaningful interpretation of the RCT findings, patient populations on the three floors will be compared at the beginning, during, and at the end of the study. The following variables will be used to compare patient populations:

- Colonization pressure (CP) is a measure of the MRSA reservoir on the unit. CP will be

calculated at the onset of the RCT and then bi-weekly (Number of MRSA patient-days × 100 ÷ Total Number of Patient Days).

- Average Braden scale score (BSS) for patients on each unit is measured to predict a

pressure ulcer risk. It is one of the measures of patient's clinical complexity. It is calculated by examining six patient criteria (sensory perception, skin moisture, physical activity, mobility, nutrition, friction and shear). BSS will be calculated at the onset of the RCT and then monthly.

- Average Case Mix Index (CMI) is a value reflecting the daily relative weight of

resources used by an individual patient compared to a base resource level (the average resource use of the patient population). The CMI value is not a dollar amount; rather it is a relative value and an indirect marker of patient's clinical complexity. CMI will be calculated at the onset of the RCT and then quarterly. Patient information will be de-identified for privacy reasons, before analysis of the study

data - logistic regression, to compare the rates of MRSA incidence and time to MRSA

conversion on intervention and control units.

Eligibility

Minimum age: N/A. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- MRSA-negative (at enrollment) inpatient of Complex Continuing Care program

Exclusion Criteria:

- MRSA-positive (at enrollment) inpatient of Complex Continuing Care program

Locations and Contacts

Baycrest Hospital, Complex Continuing Care program, Toronto, Ontario M6A 2E1, Canada
Additional Information

Starting date: August 2013
Last updated: February 20, 2015

Page last updated: August 23, 2015

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