Friday, April 6, 2012

Household Staphylococcus aureus Decolonization- Effective or Not?

Community-associated Staphylococcus aureus continues to vex as a cause of skin and soft tissue infections. 

A study published in Clinical Infectious Diseases tackles the problem of patient  S. aureus decolonizationThe investigators compared 2 approaches to S. aureus eradication: decolonizing the entire household versus decolonizing the index case alone.

Among 126 cases completing 12-months of follow-up, S. aureus was eradicated from 54% of the index group versus 66% of the household group (P = .28). Over 12 months, recurrent skin and soft tissue infections (SSTI)  by index cases were self reported in 72% of cases in the index group and 52% in the household group (P = .02). Also, SSTI incidence in household contacts was significantly lower in the household versus index group during the first 6 months; this trend continued at 12 months.

Household decolonization was not more successful than individual decolonization in eradicating S. aureus from carriers. Decolonization of the households, however, resulted in fewer recurrent infection in both the index case and in household members.

This is an interesting study and the findings are by no means definitive. The infected cases were children, so this strategy may not apply fully to adults. Neverthless, for patients with recurrent staphylococcal skin infections, screening and decolonization of household members may be a reasonable next step.

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