长期护理设施中无需隔离的检测、教育、研究和去定植 (DERAIL_MRSA)
2019年9月9日 更新者：NorthShore University HealthSystem
长期护理中无需隔离的检测、教育、研究和去定植以控制 (DERAIL)MRSA
我们对 DERAIL MRSA 计划的假设是，人们可以安全地消除几乎所有居民（患者）的定植风险，其方式不会干扰这些设施中人员的理想生活方式，从而降低感染风险并降低通过避免可预防的疾病来降低护理成本。
研究概览
详细说明
主要终点将测量干预组与对照组相比 MRSA 定植流行率（百分比率）的降低。
一个次要终点是比较干预组和对照组中 MRSA 疾病的发生率（每 1,000 名患者和 10,000 个患者日的感染数）。
另一个次要终点是确定 MRSA 筛查和去定植的成本，并将其与对照组的 MRSA 疾病治疗成本（药物成本和任何需要住院治疗 MRSA 感染治疗的费用）进行比较。
实现我们控制 MRSA 的主要目标也将证明研究人员旨在实现的两个次要目标：一个是针对 LTCF 中特定医疗保健相关感染问题的科学、有计划的方法可以解决这些问题，另一个是急性疾病之间的伙伴关系和长期护理（例如，持续至少 5 年的关系）有利于处理整个美国医疗保健连续体的患者安全和质量实践。
研究类型
观察性的
注册 (实际的)
22302
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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Illinois
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Evanston、Illinois、美国、60201
- Northshore University Healthsystem Research Institute
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 及以上 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
纳入标准：
- 随机选择 18 个 LTCF 护理单位的所有患者作为干预或控制单位
排除标准：
- 选择不参加该计划的患者
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
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干涉
MRSA 的主动监测检测和阳性受试者的去定植
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5 天莫匹罗星钙 2% 每天两次用于鼻孔和任何开放性伤口加上沐浴或淋浴用 4% 氯己定用作液体肥皂
其他名称：
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控制
通常的护理标准
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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记录入院测试和阳性人员立即去定植方案的有效性，以减少长期护理机构 (LTCF) 中的 MRSA 定植流行率
大体时间：12个月和24个月
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感染控制集群随机试验：测量干预组与对照组相比 MRSA 定植流行率（率）的降低
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12个月和24个月
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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进一步制定感染控制外展计划，旨在为 LTCF 特定的传染病预防提供专家指导
大体时间：2年
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比较干预组和对照组中 MRSA 疾病的发生率。
确定 MRSA 筛查和去定植的成本，并将其与对照组的 MRSA 疾病治疗成本（药物成本和任何需要住院治疗 MRSA 感染治疗的费用）进行比较。
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2年
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
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- Suetens C, Niclaes L, Jans B, Verhaegen J, Schuermans A, Van Eldere J, Buntinx F. Methicillin-resistant Staphylococcus aureus colonization is associated with higher mortality in nursing home residents with impaired cognitive status. J Am Geriatr Soc. 2006 Dec;54(12):1854-60. doi: 10.1111/j.1532-5415.2006.00972.x.
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- Hughes CM, Smith MB, Tunney MM. Infection control strategies for preventing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes for older people. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD006354. doi: 10.1002/14651858.CD006354.pub2.
- Gorwitz RJ, Kruszon-Moran D, McAllister SK, McQuillan G, McDougal LK, Fosheim GE, Jensen BJ, Killgore G, Tenover FC, Kuehnert MJ. Changes in the prevalence of nasal colonization with Staphylococcus aureus in the United States, 2001-2004. J Infect Dis. 2008 May 1;197(9):1226-34. doi: 10.1086/533494.
- Davis KA, Stewart JJ, Crouch HK, Florez CE, Hospenthal DR. Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital admission and its effect on subsequent MRSA infection. Clin Infect Dis. 2004 Sep 15;39(6):776-82. doi: 10.1086/422997. Epub 2004 Aug 27.
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- Centers for Disease Control and Prevention (CDC). Trends in tuberculosis--United States, 2004. MMWR Morb Mortal Wkly Rep. 2005 Mar 18;54(10):245-9. Erratum In: MMWR Morb Mortal Wkly Rep. 2005 Jun 8;293(22):2712.
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- Perl TM, Cullen JJ, Wenzel RP, Zimmerman MB, Pfaller MA, Sheppard D, Twombley J, French PP, Herwaldt LA; Mupirocin And The Risk Of Staphylococcus Aureus Study Team. Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. N Engl J Med. 2002 Jun 13;346(24):1871-7. doi: 10.1056/NEJMoa003069.
- Robicsek A, Paule SM, Hacek DM, Gonzalzles TM, Thomson RB, Peterson LR. How long after colonization does MRSA disease occur? IN: Program and Abstracts, Forty-eighth Interscience Conference on Antimicrobial Agents and Chemotherapy, Washinton, D.C., October 25-28, 2008. Abstract K-1708.
- Robicsek A, Hacek DM, Fisher A, Peterson LR. Progression to MRSA infection in asymptomatic carriers (AC) detected through a hospital-based universal surveillance and decolonization program. IN: Program and Abstracts. Forty-fourth Annual Meeting, Infectious Diseases Society of America, Toronto, Canada, October 12-15, 2006. Abstract 390.
- Hacek D, Paule S, Small M, Gottschall R, Thomson R, Peterson L. Comparison of colisitin naladixic agar (CNA), mannitol salt agar (MS) and phenol mannitol broth with antibiotics (PMB) for the recovery of Staphylococcus aureus (SA) from nasal swabs. Abstracts of the One-hundreth and third Annual Meeting of the American Society for Microbiology,Washinto, DC. May 18-22,2003. Abstract C-323.
- Paule S, Robicsek A, Suseno M, Kaul KL, Peterson LR. Incidence of mupirocin resistance in methicillin-resistant Staphylococcus aureus (MRSA) during universal surveillance and decolonization. IN: Program and Abstracts, Forty-sixth Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, CA, September 27-30,2006. Abstract C2-1149.
- Peterson LR, Boehm S, Beaumont JL, Patel PA, Schora DM, Peterson KE, Burdsall D, Hines C, Fausone M, Robicsek A, Smith BA. Reduction of methicillin-resistant Staphylococcus aureus infection in long-term care is possible while maintaining patient socialization: A prospective randomized clinical trial. Am J Infect Control. 2016 Dec 1;44(12):1622-1627. doi: 10.1016/j.ajic.2016.04.251. Epub 2016 Aug 1.
- Schora DM, Boehm S, Das S, Patel PA, O'Brien J, Hines C, Burdsall D, Beaumont J, Peterson K, Fausone M, Peterson LR. Impact of Detection, Education, Research and Decolonization without Isolation in Long-term care (DERAIL) on methicillin-resistant Staphylococcus aureus colonization and transmission at 3 long-term care facilities. Am J Infect Control. 2014 Oct;42(10 Suppl):S269-73. doi: 10.1016/j.ajic.2014.05.011.
- Das S, Anderson CJ, Grayes A, Mendoza K, Harazin M, Schora DM, Peterson LR. Nasal Carriage of Epidemic Methicillin-Resistant Staphylococcus aureus 15 (EMRSA-15) Clone Observed in Three Chicago-Area Long-Term Care Facilities. Antimicrob Agents Chemother. 2013 Sep;57(9):4551-4553. doi: 10.1128/AAC.00528-13. Epub 2013 Jun 24.
有用的网址
- Last assessed March 21, 2010
- HHS Action Plan to Prevent Healthcare-Associated Infections. Health and Human Services. 2009. Last accessed March 13,2010
- World Health Organization. The Stop TB strategy. WHO 2006. Last accessed March 13,2010
- McCaughey B. To catch a deadly germ. New York Times 11/14/2006
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2010年10月1日
初级完成 (实际的)
2013年12月1日
研究完成 (实际的)
2014年11月1日
研究注册日期
首次提交
2011年2月23日
首先提交符合 QC 标准的
2011年2月23日
首次发布 (估计)
2011年2月24日
研究记录更新
最后更新发布 (实际的)
2019年9月11日
上次提交的符合 QC 标准的更新
2019年9月9日
最后验证
2019年9月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.