Evaluating Personal and Environmental Decolonization Strategies for Children With Skin and Soft Tissue Infection and Their Households — A Randomized Clinical Trial

作者：Alaina L Robinson, Mary G. Boyle, Patrick G. Hogan, Sara Malone, Melissa J. Krauss, Lisa Richardson, Melanie L. Sullivan, Tyler Walsh, Rinat Tal, Lauren Walsh, Ryley M. Thompson, Katelyn L. Parrish, Carol E. Muenks, Carey‐Ann D. Burnham, Stephanie A. Fritz · 发表于：Clinical Infectious Diseases · 年份：2025 · DOI：10.1093/cid/ciaf627 · 被引用次数：3 · 研究领域：Neonatal skin health care、Streptococcal Infections and Treatments、Dermatological diseases and infestations

BACKGROUND: Staphylococcus aureus colonization predisposes to skin and soft tissue infection (SSTI). Given the waning effectiveness of decolonization, we evaluated periodic-personal decolonization and household environmental decontamination to reduce SSTIs among households affected by S. aureus. METHODS: Households of children with community-associated S. aureus SSTI participated in an open-label randomized trial. After baseline decolonization, households were randomized 1:1:1 to a 3-month decolonization intervention: (1) periodic-personal (twice weekly chlorhexidine bathing and monthly intranasal mupirocin application); (2) environmental-hygiene (weekly household surface disinfection and enhanced laundry measures); or (3) integrated-approach of both periodic-personal and environmental-hygiene. Over 9 months, participants and household surfaces were sampled at 5 study visits to detect S. aureus; SSTI incidence was recorded. The primary outcome was household-level cumulative SSTI at 3 months, comparing the integrated-approach to the combined personal-periodic and environmental-hygiene groups. RESULTS: Between 2015 and 2021, 196 index patients and their household contacts (n = 623) were enrolled. Cumulative SSTI incidence did not differ between groups during the 3-month intervention. In index patients and household contacts with SSTI in the year prior to enrollment, SSTI incidence was lower among the integrated-approach at 6- and 9-months compared to the combined periodic-perso...