Study of the Impact of a Targeted Decolonization of S. Aureus Persistent Carriers

• Status: Recruiting
• Trial end date: 2024-10-01
• Target enrollment: 0
• Participant gender: All

Summary

S. aureus nasal carriage is a well-known risk factor for S. aureus infections in hemodialysis (HD) patients. Strains of carriage and infections are the same in >80% of cases We recently shown that persistent carriers of S. aureus, not intermittent ones are at increased risk of staphylococcal infections in HD. Thanks to a new algorithm developped based on one nasal sample the determination of carriage status (persistent, intermittent or non-carriers) among patients is easy. Mupirocin use in HD have been shown to reduce significantly S. aureus infections however, multiples schedules of decolonization have been proposed to all S. aureus carriers. To date, there is no national guideline for decolonization of S. aureus in HD. We showed that only 50% of HD centers in France propose screening and decolonization of S. aureus carriers. The aim of the study is therefore to evaluate the impact of a targeted decolonization of S. aureus persistent carriers using mupirocin nasal ointment and chlorhexidine baths during 5 days on the occurrence of S. aureus infections in HD patients compared to the absence of decolonization using a randomized open study methodology.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Centre Hospitalier Universitaire de Saint Etienne
• Collaborator: Ministry of Health, France

Criteria

Inclusion Criteria:

• Adults (age ≥ 18 years-old)

• Patient under chronic hemodialysis

• Patent that accepted to participate in the study with a written consent form signed

Exclusion Criteria:

• Patients under peritoneal dialysis

• Patients with an active infection at the time of inclusion

• Patients previously treated by mupirocin and chlorhexidine for decolonization purpose

• Patients that received antimicrobials active on S. aureus during the month before the inclusion

• Patients with allergy to mupirocin or chlorhexidine

• Patients treated by hemodialysis transiently (non-terminal kidney failure)

• Pregnancy