Recurrent skin and soft tissue infections (SSTI) caused by Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) or Methicillin-Sensitive Staphylococcus aureus (CA-MSSA) present treatment challenges. This community-based trial examined the effectiveness of an evidence-based intervention (CDC Guidelines, topical decolonization, surface decontamination) to reduce SSTI recurrence, mitigate household contamination/transmission, and improve patient-reported outcomes. Participants (n = 186) were individuals with confirmed MRSA(+)/MSSA(+) SSTIs and their household members. During home visits; Community Health Workers/Promotoras provided hygiene instructions; a five-day supply of nasal mupirocin; chlorhexidine for body cleansing; and household disinfecting wipes (Experimental; EXP) or Usual Care Control (UC CON) pamphlets. Primary outcome was six-month SSTI recurrence from electronic health records (EHR). Home visits (months 0; 3) and telephone assessments (months 0; 1; 6) collected self-report data. Index patients and participating household members provided surveillance culture swabs. Secondary outcomes included household surface contamination; household member colonization and transmission; quality of life; and satisfaction with care. There were no significant differences in SSTI recurrence between EXP and UC in the intent-to-treat cohort (n = 186) or the enrolled cohort (n = 119). EXP participants showed reduced but non-significant colonization rates. EXP and UC did not differ in household member transmission, contaminated surfaces, or patient-reported outcomes. This intervention did not reduce clinician-reported MRSA/MSSA SSTI recurrence. Taken together with other recent studies that employed more intensive decolonization protocols, it is possible that a promotora-delivered intervention instructing treatment for a longer or repetitive duration may be effective and should be examined by future studies.

中文翻译：

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家庭干预预防 CA-MRSA 感染复发的比较有效性研究

由社区相关耐甲氧西林金黄色葡萄球菌(CA-MRSA) 或甲氧西林敏感金黄色葡萄球菌(CA-MSSA)引起的复发性皮肤和软组织感染 (SSTI) 给治疗带来了挑战。这项基于社区的试验检查了循证干预（CDC 指南、局部去定植、表面去污）在减少 SSTI 复发、减轻家庭污染/传播和改善患者报告结果方面的有效性。参与者 ( n= 186) 是确诊 MRSA(+)/MSSA(+) SSTI 的个人及其家庭成员。家访期间；社区卫生工作者/宣传员提供卫生指导；五天的鼻用莫匹罗星供应量；用于身体清洁的氯己定；和家用消毒湿巾（实验性；EXP）或日常护理控制 (UC CON) 小册子。主要结果是来自电子健康记录 (EHR) 的 6 个月 SSTI 复发。家访（第 0 个月；3 个月）和电话评估（第 0 个月；1；6 个月）收集了自我报告数据。索引患者和参与的家庭成员提供了监测培养拭子。次要结果包括家庭表面污染；家庭成员定植和传播；生活质量; 和满意的照顾。在意向治疗队列（n = 186）或入组队列（n = 119）中，EXP 和 UC 之间的 SSTI 复发没有显着差异。EXP 参与者表现出降低但不显着的定植率。EXP 和 UC 在家庭成员传播、污染表面或患者报告结果方面没有差异。这种干预并没有减少临床医生报告的 MRSA/MSSA SSTI 复发。与最近采用更密集去定植方案的其他研究相结合，有可能由促进剂提供的干预指导更长或重复持续时间的治疗可能是有效的，并且应该在未来的研究中进行检查。EXP 和 UC 在家庭成员传播、污染表面或患者报告结果方面没有差异。这种干预并没有减少临床医生报告的 MRSA/MSSA SSTI 复发。与最近采用更密集去定植方案的其他研究相结合，有可能由促进剂提供的干预指导更长或重复持续时间的治疗可能是有效的，并且应该在未来的研究中进行检查。EXP 和 UC 在家庭成员传播、污染表面或患者报告结果方面没有差异。这种干预并没有减少临床医生报告的 MRSA/MSSA SSTI 复发。与最近采用更密集去定植方案的其他研究相结合，有可能由促进剂提供的干预指导更长或重复持续时间的治疗可能是有效的，并且应该在未来的研究中进行检查。