- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02572791
Staph Household Intervention for Eradication (SHINE) (SHINE)
July 27, 2023 updated by: Stephanie A. Fritz, Washington University School of Medicine
Integrating Personal and Household Environmental Hygiene Measures to Prevent Methicillin-Resistant Staphylococcus Aureus Infection
The investigators propose a pragmatic comparative effectiveness trial evaluating several decolonization strategies in patients with Staphylococcus aureus infection, their household contacts, and household environmental surfaces.
The central hypothesis of this proposal is that an integrated approach of periodic personal and household environmental hygiene will reduce S. aureus transmission in households and subsequently decrease the incidence of skin and soft tissue infections (SSTI).
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Detailed Description
Patients with active or recent S. aureus SSTI will be recruited from St. Louis Children's Hospital and community pediatric practices affiliated with the investigators practice-based research network.
All participants (index patients and their household contacts) will perform a baseline S. aureus decolonization protocol for 5 days consisting of enhanced hygiene measures, application of mupirocin antibiotic ointment to the anterior nares twice daily, and daily body washes with chlorhexidine antiseptic.
Following the 5-day baseline decolonization regimen, households will be randomized to one of three intervention groups: 1) Periodic personal decolonization performed by all household members, to include chlorhexidine body washes twice weekly for 3 months and application of intranasal mupirocin for 5 consecutive days each month for 3 months; 2) Household environmental hygiene, including targeted cleaning of household surfaces and laundering of bed linens, weekly for 3 months; and 3) Integrated periodic personal decolonization and household environmental hygiene for 3 months.
Households will be followed prospectively (1, 3, 6, and 9 months following randomization) to measure the prevalence of S. aureus colonization in the participants, household environmental surfaces, and pet dogs and cats and to document the incidence of recurrent SSTI.
Molecular strain typing will be performed on all recovered S. aureus isolates to illuminate transmission dynamics and the effects of the decolonization measures on genetic epidemiology.
Lastly, the investigators will assess resistance to the prescribed topical antimicrobials at baseline and longitudinal samplings.
Study Type
Interventional
Enrollment (Actual)
835
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Missouri
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Saint Louis, Missouri, United States, 63110
- Washington University School of Medicine
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Saint Louis, Missouri, United States, 63110
- St. Louis Children's Hospital
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
No older than 18 years (Child, Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Patients 18 years of age and younger
- Confirmed (i.e., culture-positive) active or recent (within the past 2 months) S. aureus cutaneous infections
- Reside within 75 miles of St. Louis Children's Hospital
- Provide written, informed consent, or consent is provided by a parent or legal guardian
Exclusion Criteria:
- Patients with nosocomial infections (i.e., >48 hours after hospitalization)
- Patients with traditional risk factors for HA-MRSA (e.g., immunodeficiency, indwelling catheter or percutaneous medical device, undergoing dialysis, presenting with a surgical site infection, or residing in a long-term care facility within the past year).
- Patients who are unable to give consent or for whom consent is not obtained
- Patients refusing home environmental cultures by the study team
- Patients without a permanent home (e.g., living in a shelter or group home)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Periodic personal decolonization
All household participants will perform chlorhexidine body washes twice weekly for 3 months and apply mupirocin ointment to the anterior nares twice daily for five consecutive days each month for 3 months.
|
Other Names:
Other Names:
|
Experimental: Household environmental hygiene
In addition to their usual cleaning, households will be asked to perform targeted household hygiene focusing on sources known to harbor S. aureus and serve as reservoirs for transmission.
|
|
Experimental: Integrated personal/household hygiene
Participants in households randomized to this arm will perform the Periodic Personal Decolonization plus the Household Environmental Hygiene, described above in arms 1 and 2.
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Other Names:
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of SSTI
Time Frame: 3 months after randomization
|
We will compare the incidence of SSTI at the household level (i.e., occurring in any household member) 3 months after randomization between the 3 intervention groups.
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3 months after randomization
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Prevalence of S. aureus colonization in index patients, household contacts, pet dogs and cats, and household surfaces
Time Frame: 9 months (collected at baseline, 1 month, 3 months, 6 months, and 9 months).
|
Describe baseline and longitudinal prevalence of MRSA colonization in index patients, household contacts, pet dogs and cats, and household surfaces and compare between the 3 intervention groups.
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9 months (collected at baseline, 1 month, 3 months, 6 months, and 9 months).
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Incidence of SSTI
Time Frame: 1 month, 6 months, and 9 months after randomization
|
We will compare the incidence of SSTI at the household level (i.e., occurring in any household member) 1 month, 6 months, and 9 months after randomization between the 3 groups.
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1 month, 6 months, and 9 months after randomization
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Confirmed S. aureus Infection
Time Frame: 9 months
|
We will compare the development of a confirmed S. aureus infection between participants in the 3 groups over 9 months at the household and individual level.
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9 months
|
Number of patients with adverse events due to study intervention
Time Frame: 3 months
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We will describe the number of participants with adverse events due to study intervention (e.g., rhinorrhea, rash, dry skin) and compare between the three groups.
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3 months
|
Mupirocin resistance
Time Frame: 9 months
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Measure the prevalence of mupirocin resistance in S. aureus strains recovered at serial samplings over the study period of 9 months.
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9 months
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Number of participants adhering to study intervention procedures
Time Frame: 3 months
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We will describe the number of participants completing chlorhexidine baths, mupirocin applications, and household hygiene measures.
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3 months
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Stephanie A Fritz, MD, MSCI, Washington University School of Medicine
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
October 1, 2015
Primary Completion (Estimated)
December 1, 2023
Study Completion (Estimated)
June 1, 2024
Study Registration Dates
First Submitted
October 5, 2015
First Submitted That Met QC Criteria
October 7, 2015
First Posted (Estimated)
October 9, 2015
Study Record Updates
Last Update Posted (Actual)
July 28, 2023
Last Update Submitted That Met QC Criteria
July 27, 2023
Last Verified
July 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Disease Attributes
- Bacterial Infections and Mycoses
- Gram-Positive Bacterial Infections
- Infections
- Communicable Diseases
- Bacterial Infections
- Staphylococcal Infections
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents, Local
- Anti-Infective Agents
- Enzyme Inhibitors
- Dermatologic Agents
- Anti-Bacterial Agents
- Protein Synthesis Inhibitors
- Disinfectants
- Mupirocin
- Chlorhexidine
- Chlorhexidine gluconate
Other Study ID Numbers
- 3177 60559
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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