{"indexed":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T04:59:49Z","timestamp":1509080389541},"reference-count":35,"publisher":"Cambridge University Press (CUP)","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec id=\"S0899823X14000749_abs1\" sec-type=\"general\"><jats:title>OBJECTIVE<\/jats:title><jats:p>The risk of carrying methicillin-resistant<jats:italic>Staphylococcus aureus<\/jats:italic>(MRSA) is higher among nursing home (NH) residents than in the general population. However, control strategies are not clearly defined in this setting. In this study, we compared the impact of standard precautions either alone (control) or combined with screening of residents and decolonization of carriers (intervention) to control MRSA in NHs.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X14000749_abs2\" sec-type=\"general\"><jats:title>DESIGN<\/jats:title><jats:p>Cluster randomized controlled trial<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X14000749_abs3\" sec-type=\"general\"><jats:title>SETTING<\/jats:title><jats:p>NHs of the state of Vaud, Switzerland<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X14000749_abs4\" sec-type=\"general\"><jats:title>PARTICIPANTS<\/jats:title><jats:p>Of 157 total NHs in Vaud, 104 (67%) participated in the study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X14000749_abs5\" sec-type=\"general\"><jats:title>INTERVENTION<\/jats:title><jats:p>Standard precautions were enforced in all participating NHs, and residents underwent MRSA screening at baseline and 12 months thereafter. All carriers identified in intervention NHs, either at study entry or among newly admitted residents, underwent topical decolonization combined with environmental disinfection, except in cases of MRSA infection, MRSA bacteriuria, or deep skin ulcers.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X14000749_abs6\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>NHs were randomly allocated to a control group (51 NHs, 2,412 residents) or an intervention group (53 NHs, 2,338 residents). Characteristics of NHs and residents were similar in both groups. The mean screening rates were 86% (range, 27%\u2013100%) in control NHs and 87% (20%\u2013100%) in intervention NHs. Prevalence of MRSA carriage averaged 8.9% in both control NHs (range, 0%\u201343%) and intervention NHs (range, 0%\u201338%) at baseline, and this rate significantly declined to 6.6% in control NHs and to 5.8% in intervention NHs after 12 months. However, the decline did not differ between groups (<jats:italic>P<\/jats:italic>=.66).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X14000749_abs7\" sec-type=\"conclusion\"><jats:title>CONCLUSION<\/jats:title><jats:p>Universal screening followed by decolonization of carriers did not significantly reduce the prevalence of the MRSA carriage rate at 1 year compared with standard precautions.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic>2015;00(0): 1\u20138<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2014.74","type":"article-journal","created":{"date-parts":[[2015,1,12]],"date-time":"2015-01-12T05:53:00Z","timestamp":1421041980000},"page":"401-408","source":"Crossref","is-referenced-by-count":8,"title":"Universal Screening and Decolonization for Control of MRSA in Nursing Homes: A Cluster Randomized Controlled Study","prefix":"10.1017","volume":"36","author":[{"given":"Cristina","family":"Bellini","affiliation":[]},{"given":"Christiane","family":"Petignat","affiliation":[]},{"given":"Eric","family":"Masserey","affiliation":[]},{"given":"Christophe","family":"B\u00fcla","affiliation":[]},{"given":"Bernard","family":"Burnand","affiliation":[]},{"given":"Valentin","family":"Rousson","affiliation":[]},{"given":"Dominique S.","family":"Blanc","affiliation":[]},{"given":"Giorgio","family":"Zanetti","affiliation":[]}],"member":"56","published-online":{"date-parts":[[2015,1,12]]},"reference":[{"key":"S0899823X14000749_ref36","volume":"51","first-page":"311","year":"1997","journal-title":"Am 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