Research news: July 2013
N Engl J Med2013; doi:10.1056/NEJMoa1207290
A trial randomised 43 US hospitals to one of three strategies for combating infections in intensive care units (ICUs). The first screened for meticillin resistant Staphylococcus aureus (MRSA) and isolated those who screened positive (group 1). The second added decolonisation of MRSA carriers with intranasal mupirocin and chlorhexidine bathing for five days (group 2). The third comprised decolonisation, with intranasal mupirocin over five days and chlorhexidine bathing for the entire stay, of all patients, without screening (group 3).
Nearly 50 000 patients were treated in the participating intensive care units during a one year baseline period and nearly 75 000 in an 18 month intervention period. The units had three months in between to adapt to the new regimens.
In group 1, the intervention had no effect on any of the outcomes compared with the baseline period. This included MRSA clinical isolates (3.2 v 3.4 events/1000 days),