{"doi":"10.1093/cid/ciaf627","title":"Evaluating Personal and Environmental Decolonization Strategies for Children With Skin and Soft Tissue Infection and Their Households — A Randomized Clinical Trial","abstract":"BACKGROUND: Staphylococcus aureus colonization predisposes to skin and soft tissue infection (SSTI). Given the waning effectiveness of decolonization, we evaluated periodic-personal decolonization and household environmental decontamination to reduce SSTIs among households affected by S. aureus. METHODS: Households of children with community-associated S. aureus SSTI participated in an open-label randomized trial. After baseline decolonization, households were randomized 1:1:1 to a 3-month decolonization intervention: (1) periodic-personal (twice weekly chlorhexidine bathing and monthly intranasal mupirocin application); (2) environmental-hygiene (weekly household surface disinfection and enhanced laundry measures); or (3) integrated-approach of both periodic-personal and environmental-hygiene. Over 9 months, participants and household surfaces were sampled at 5 study visits to detect S. aureus; SSTI incidence was recorded. The primary outcome was household-level cumulative SSTI at 3 months, comparing the integrated-approach to the combined personal-periodic and environmental-hygiene groups. RESULTS: Between 2015 and 2021, 196 index patients and their household contacts (n = 623) were enrolled. Cumulative SSTI incidence did not differ between groups during the 3-month intervention. In index patients and household contacts with SSTI in the year prior to enrollment, SSTI incidence was lower among the integrated-approach at 6- and 9-months compared to the combined periodic-personal and environmental-hygiene groups. In multivariable analyses, prior year SSTI was associated with subsequent SSTI; intervention group was not significant. All interventions reduced methicillin-resistant S. aureus, but not methicillin-susceptible S. aureus, personal colonization over 9 months. CONCLUSIONS: While an integrated-approach of prolonged personal and environmental decolonization reduced SSTIs among participants with prior year SSTI, prior SSTI strongly predicted SSTI incidence longitudinally. Novel prevention strategies are needed.","journal":"Clinical Infectious Diseases","year":2025,"id":535515,"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":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9577,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":498311,"name":"Mary G. Boyle","orcid":null,"position":1,"is_corresponding":false},{"id":486329,"name":"Patrick G. Hogan","orcid":"0000-0003-3196-9618","position":2,"is_corresponding":false},{"id":572817,"name":"Sara Malone","orcid":"0000-0002-0361-8733","position":3,"is_corresponding":false},{"id":331109,"name":"Melissa J. Krauss","orcid":"0000-0002-8726-7394","position":4,"is_corresponding":false},{"id":939006,"name":"Lisa Richardson","orcid":"0009-0008-1277-3250","position":5,"is_corresponding":false},{"id":497195,"name":"Melanie L. Sullivan","orcid":"0009-0007-7410-8582","position":6,"is_corresponding":false},{"id":756050,"name":"Tyler Walsh","orcid":"0009-0002-7704-6149","position":7,"is_corresponding":false},{"id":1419134,"name":"Rinat Tal","orcid":"0009-0008-2660-8897","position":8,"is_corresponding":false},{"id":1419135,"name":"Lauren Walsh","orcid":"0000-0003-3961-8230","position":9,"is_corresponding":false},{"id":498312,"name":"Ryley M. Thompson","orcid":null,"position":10,"is_corresponding":false},{"id":498309,"name":"Katelyn L. Parrish","orcid":null,"position":11,"is_corresponding":false},{"id":497194,"name":"Carol E. Muenks","orcid":"0000-0003-4294-8134","position":12,"is_corresponding":false},{"id":246794,"name":"Carey‐Ann D. Burnham","orcid":"0000-0002-1137-840X","position":13,"is_corresponding":false},{"id":413171,"name":"Stephanie A. Fritz","orcid":"0000-0002-8602-5879","position":14,"is_corresponding":false},{"id":1419595,"name":"Alaina L Robinson","orcid":null,"position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-19T02:51:56.297114Z","pmid":"41276461","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}