{"doi":"10.1093/cid/ciac402","title":"Chlorhexidine and Mupirocin for Clearance of Methicillin-Resistant <i>Staphylococcus aureus</i> Colonization After Hospital Discharge: A Secondary Analysis of the Changing Lives by Eradicating Antibiotic Resistance Trial","abstract":"BACKGROUND: The CLEAR Trial demonstrated that a multisite body decolonization regimen reduced post-discharge infection and hospitalization in methicillin-resistant Staphylococcus aureus (MRSA) carriers. Here, we describe decolonization efficacy. METHODS: We performed a large, multicenter, randomized clinical trial of MRSA decolonization among adult patients after hospital discharge with MRSA infection or colonization. Participants were randomized 1:1 to either MRSA prevention education or education plus decolonization with topical chlorhexidine, oral chlorhexidine, and nasal mupirocin. Participants were swabbed in the nares, throat, axilla/groin, and wound (if applicable) at baseline and 1, 3, 6, and 9 months after randomization. The primary outcomes of this study are follow-up colonization differences between groups. RESULTS: Among 2121 participants, 1058 were randomized to decolonization. By 1 month, MRSA colonization was lower in the decolonization group compared with the education-only group (odds ration [OR] = 0.44; 95% confidence interval [CI], .36-.54; P ≤ .001). A similar magnitude of reduction was seen in the nares (OR = 0.34; 95% CI, .27-.42; P < .001), throat (OR = 0.55; 95% CI, .42-.73; P < .001), and axilla/groin (OR = 0.57; 95% CI, .43-.75; P < .001). These differences persisted through month 9 except at the wound site, which had a relatively small sample size. Higher regimen adherence was associated with lower MRSA colonization (P ≤ .01). CONCLUSIONS: In a randomized, clinical trial, a repeated post-discharge decolonization regimen for MRSA carriers reduced MRSA colonization overall and at multiple body sites. Higher treatment adherence was associated with greater reductions in MRSA colonization.","journal":"Clinical Infectious Diseases","year":2022,"id":275372,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9573,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":944498,"name":"Raveena Singh","orcid":"0000-0003-4262-3663","position":1,"is_corresponding":false},{"id":944878,"name":"Samantha J. 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McKinnell","orcid":null,"position":4,"is_corresponding":false},{"id":336884,"name":"Steven Park","orcid":"0000-0002-6757-1559","position":5,"is_corresponding":false},{"id":944879,"name":"Tom Tjoa","orcid":null,"position":6,"is_corresponding":false},{"id":944499,"name":"Justin Chang","orcid":"0000-0002-8523-1937","position":7,"is_corresponding":false},{"id":944880,"name":"Syma Rashid","orcid":null,"position":8,"is_corresponding":false},{"id":822608,"name":"Raul Macias Gil","orcid":"0000-0003-3875-5209","position":9,"is_corresponding":false},{"id":944881,"name":"Lauren Heim","orcid":null,"position":10,"is_corresponding":false},{"id":944882,"name":"Adrijana Gombosev","orcid":null,"position":11,"is_corresponding":false},{"id":818414,"name":"Diane Kim","orcid":"0009-0001-0444-5096","position":12,"is_corresponding":false},{"id":944500,"name":"Eric Cui","orcid":"0009-0005-5632-8149","position":13,"is_corresponding":false},{"id":944883,"name":"Jennifer Lequieu","orcid":null,"position":14,"is_corresponding":false},{"id":944884,"name":"Chenghua Cao","orcid":null,"position":15,"is_corresponding":false},{"id":944885,"name":"Suzie S. Hong","orcid":null,"position":16,"is_corresponding":false},{"id":818415,"name":"Ellena M. Peterson","orcid":"0000-0001-6633-831X","position":17,"is_corresponding":false},{"id":944886,"name":"Kaye Evans","orcid":null,"position":18,"is_corresponding":false},{"id":944501,"name":"Bryn Launer","orcid":"0000-0002-3802-8709","position":19,"is_corresponding":false},{"id":66705,"name":"Steven Tam","orcid":null,"position":20,"is_corresponding":false},{"id":944502,"name":"Michael Bolaris","orcid":"0000-0002-7787-9928","position":21,"is_corresponding":false},{"id":266137,"name":"Susan S. Huang","orcid":"0000-0001-6748-3447","position":22,"is_corresponding":false},{"id":451651,"name":"Loren G. 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