Chlorhexidine-Impregnated Cloths to Prevent Skin and Soft-Tissue Infection in Marine Recruits: A Cluster-Randomized, Double-Blind, Controlled Effectiveness Trial

Background.Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) causes skin and soft-tissue infection (SSTI) in military recruits.Objective.To evaluate the effectiveness of 2% Chlorhexidine gluconate (CHG)-impregnated cloths in reducing rates of SSTI and S. aureus colonization among military recruits.Design.A cluster-randomized (by platoon), double-blind, controlled effectiveness trial.Setting.Marine Officer Candidate School, Quantico, Virginia, 2007.Participants.Military recruits.Intervention.Application of CHG-impregnated or control (Comfort Bath; Sage) cloths applied over entire body thrice weekly.Measurements.Recruits were monitored daily for SSTI. Baseline and serial nasal and/or axillary swabs were collected to assess S. aureus colonization.Results.Of 1,562 subjects enrolled, 781 (from 23 platoons) underwent CHG-impregnated cloth application and 781 (from 21 platoons) underwent control cloth application. The rate of compliance (defined as application of 50% or more of wipes) at 2 weeks was similar (CHG group, 63%; control group, 67%) and decreased over the 6-week period. The mean 6-week SSTI rate in the CHG-impregnated cloth group was 0.094, compared with 0.071 in the control group (analysis of variance model rate difference, 0.025 ± 0.016; P = .14). At baseline, 43% of subjects were colonized with methicillin-susceptible S. aureus (MSSA), and 2.1% were colonized with MRSA. The mean incidence of colonization with MSSA was 50% and 61% (P = .026) and with MRSA was 2.6% and 6.0% (P = .034) for the CHG-impregnated and control cloth groups, respectively.Conclusions.CHG-impregnated cloths applied thrice weekly did not reduce rates of SSTI among recruits. S. aureus colonization rates increased in both groups but to a lesser extent in those assigned to the CHG-impregnated cloth Intervention. Antecedent S. aureus colonization was not a risk factor for SSTI. Additional studies are needed to identify effective measures for preventing SSTI among military recruits.Clinical Trials Registration.ClinicalTrials.gov identifier: NCT00475930.

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APPLICATION OF PLASMA FLOWS IN SOFT TISSUE INFECTION

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2017-176-1-65-69 ◽

2017 ◽

Vol 176 (1) ◽

pp. 65-69 ◽

Cited By ~ 1

Author(s):

A. M. Shulutko ◽

E. G. Osmanov ◽

T. R. Gogokhiya ◽

S. E. Khmyrova

Keyword(s):

Soft Tissue ◽

Soft Tissue Infection ◽

Microbial Contamination ◽

Local Therapy ◽

Pain Syndrome ◽

Tissue Infection ◽

Control Group ◽

Air Plasma ◽

Plasma Flows ◽

Results Of Treatment

The authors analyzed the results of treatment of 489 patients with surgical soft tissue infection at the period from 2004 to 2015. The argon and air-plasma flows in different regimes were applied in following local therapy during surgical d-bridement. The results obtained were compared with results of 280 patients who were treated using common me thod (control group). There was revealed that plasma processing of necrotic suppurative focus significantly accelerated wound cleansing and following reparation of post-necrotic wounds in 1.5-1,8 times regardless the severity and extent of covering tissue lesion. The method allowed doctors to decrease significantly the rate of microbial contamination of the focus and shorten the hospital stay. Similar trends were noted in terms of fever relief, pain syndrome and other important indices.

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CARBOXY-LYMPHOTROPIC THERAPY IN TREATMENT OF SURGICAL SOFT TISSUE INFECTIONS OF LOWER EXTREMITIES

Ulyanovsk Medico-biological Journal ◽

10.34014/2227-1848-2020-1-53-62 ◽

2020 ◽

pp. 53-62 ◽

Cited By ~ 1

Author(s):

M.I. Popova ◽

S.A. Stolyarov ◽

V.A. Badeyan

Keyword(s):

Soft Tissue ◽

Soft Tissue Infection ◽

Soft Tissues ◽

Lower Extremities ◽

Main Group ◽

Tissue Infection ◽

Control Group ◽

Wound Fluid ◽

Affected Area ◽

Somatic Diseases

Introduction. So far, surgical soft tissue infection accounts for more than half of all cases seeking specialized medical attendance, and its treatment is sometimes rather difficult. The purpose of the work is to study the results of carboxy-lymphotropic therapy while treating patients with surgical soft tissue infection of the lower extremities. Materials and Methods. The study enrolled 57 patients with manifestations of surgical soft tissue infection of the lower extremities. Criteria for enrollment: patients aged 18 to 75, lack of decompensation for concomitant somatic diseases, and lack of systemic inflammatory response. Withdrawal criteria: patients with diabetes mellitus, cancer, decompensation for concomitant somatic diseases, immunodeficiency states (HIV infection, primary immunodeficiency), injecting drug use, pregnancy and lactation. All patients were divided into two groups: the main group and the control group. The main group included 29 patients who underwent carboxy-lymphotropic therapy. Patients of the control group (n=28) were treated according to the standard protocol. Patients of both groups were examined identically. The examination included the study of the wound fluid pH, bacteriological examination of the wound fluid with antibiotic sensitivity test, cytological screening and the study of the microcirculation in the affected area with a laser analyzer «LAKK – M». Results. Carboxy-lymphotropic therapy as the main treatment method allowed to reduce the duration of patients’ treatment and to accelerate the phase change in the wound process. It was proven both experimentally and clinically. Conclusion. Carboxy-lymphotropic therapy significantly improves treatment outcomes in patients with surgical soft tissue infection of the lower extremities. For patients with microcirculation disorders in the affected area, the described method should be mandatory. Keywords: surgical infection, soft tissues, carboxytherapy, lymphotropic therapy. До настоящего времени хирургические инфекции мягких тканей остаются той областью хирургии, на которую приходится более половины случаев обращения за специализированной медицинской помощью, а ее лечение представляет порой существенные трудности. Цель работы – изучить результаты применения карбокси-лимфотропной терапии при лечении пациентов с хирургической инфекцией мягких тканей нижних конечностей. Материалы и методы. Обследованы 57 пациентов с проявлениями хирургической инфекции мягких тканей нижних конечностей. Критерии включения в исследование: возраст пациентов от 18 до 75 лет, отсутствие декомпенсации по сопутствующим соматическим заболеваниям, отсутствие системной воспалительной реакции. Критерии исключения: наличие у пациентов сахарного диабета, онкологических заболеваний, декомпенсация по сопутствующим соматическим заболеваниям, иммунодефицитные состояния (ВИЧ-инфекция, первичный иммунодефицит), инъекционная наркомания, период беременности и лактации. Все пациенты были разделены на две группы – основную и контрольную. В основную вошли 29 пациентов, лечение которых осуществлялось с применением карбокси-лимфотропной терапии. Лечение 28 пациентов контрольной группы проводилось по стандартной схеме. Подход к обследованию пациентов обеих групп был одинаковым и включал в себя исследование рН раневого отделяемого, бактериологическое исследование раневого отделяемого с определением чувствительности выделенных микроорганизмов к антибиотикам, цитологическое исследование и исследование микроциркуляции зоны поражения с помощью лазерного анализатора «ЛАКК-М». Результаты. Применение карбокси-лимфотропной терапии в качестве основного метода лечения позволило сократить время пребывания пациентов на лечении, ускорить смену фаз раневого процесса, что было доказано с помощью ряда лабораторных методов, а также клинически. Выводы. Карбокси-лимфотропная терапия достоверно улучшает результаты лечения пациентов с хирургической инфекцией мягких тканей нижних конечностей. Для категории больных с нарушением микроциркуляции в зоне поражения данный способ должен являться методом выбора. Ключевые слова: хирургическая инфекция, мягкие ткани, карбокситерапия, лимфотропная терапия.

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The impact of household transmission on duration of outpatient colonization with methicillin-resistantStaphylococcus aureus

Epidemiology and Infection ◽

10.1017/s0950268810000099 ◽

2010 ◽

Vol 138 (5) ◽

pp. 683-685 ◽

Cited By ~ 19

Author(s):

E. LAUTENBACH ◽

P. TOLOMEO ◽

I. NACHAMKIN ◽

B. HU ◽

T. E. ZAOUTIS

Keyword(s):

Soft Tissue ◽

Soft Tissue Infection ◽

Tissue Infection ◽

Household Member ◽

Household Transmission ◽

The Mean ◽

Household Members ◽

The Impact ◽

Mrsa Colonization ◽

Index Cases

SUMMARYWe identified eight consecutive patients who presented with a skin or soft tissue infection due to MRSA. Of seven household members of these cases, three were colonized with MRSA. The mean duration of MRSA colonization in index cases was 33 days (range 14–104), while mean duration of colonization in household cases was 54 days (range 12–95). There was a borderline significant association between having a concurrent colonized household member and a longer duration of colonization (mean 44 daysvs. 26 days,P=0·08).

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Chlorhexidine Gluconate Reduces Transmission of Methicillin-ResistantStaphylococcus aureusUSA300 among Marine Recruits

Infection Control and Hospital Epidemiology ◽

10.1086/666631 ◽

2012 ◽

Vol 33 (8) ◽

pp. 809-816 ◽

Cited By ~ 15

Author(s):

Timothy J. Whitman ◽

Carey D. Schlett ◽

Greg A. Grandits ◽

Eugene V. Millar ◽

Katrin Mende ◽

...

Keyword(s):

Molecular Epidemiology ◽

Controlled Trial ◽

Chlorhexidine Gluconate ◽

Control Group ◽

Entire Body ◽

Double Blind ◽

Pulsed Field ◽

Military Recruits ◽

The Impact ◽

Mrsa Colonization

Background.Methicillin-resistantStaphylococcus aureus(MRSA) pulsed-field type (PFT) USA300 causes skin and soft tissue infections in military recruits and invasive disease in hospitals. Chlorhexidine gluconate (CHG) is used to reduce MRSA colonization and infection. The impact of CHG on the molecular epidemiology of MRSA is not known.Objective.To evaluate the impact of 2% CHG—impregnated cloths on the molecular epidemiology of MRSA colonization.Design.Cluster-randomized, double-blind, controlled trial.Setting.Marine Officer Candidate School, Quantico, Virginia, in 2007.Participants.Military recruits.Intervention.Thrice-weekly application of CHG-impregnated or control (Comfort Bath; Sage) cloths over the entire body.Measurements.Baseline and serial (every 2 weeks) nasal and/or axillary swab samples were assessed for MRSA colonization. Molecular analysis was performed with pulsed-field gel electrophoresis.Results.During training, 77 subjects (4.9%) acquired MRSA, 26 (3.3%) in the CHG group and 51 (6.5%) in the control group (P= .004). When analyzed for PFT, 24 subjects (3.1%) in the control group but only 6 subjects (0.8%) in the CHG group (P= .001) had USA300. Of the 167 colonizing isolates recovered from 77 subjects, 99 were recovered from the control group, including USA300 (40.4%), USA800 (38.4%), USA1000 (12.1%), and USA100 (6.1%), and 68 were recovered from the CHG group, including USA800 (51.5%), USA100 (23.5%), and USA300 (13.2%).Conclusions.CHG decreased the transmission of MRSA—more specifically, USA300—among military recruits. In addition, USA300 and USA800 outcompeted other MRSA PFTs at incident colonization. Future studies should evaluate the broad-based use of CHG to decrease transmission of USA300 in hospital settings.

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