title: A randomized, controlled trial of chlorhexidine-soaked cloths to reduce methicillin-resistant and methicillin-susceptible Staphylococcus aureus carriage prevalence in an urban jail.
abstract: OBJECTIVE
  To assess an intervention to limit community-associated methicillin-resistant Staphylococcus aureus (MRSA) dissemination.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  County Jail, Dallas, Texas.
  
  
  METHODS
  A total of 4,196 detainees in 68 detention tanks.
  
  
  METHODS
  Tanks were randomly assigned to 1 of 3 groups: in group 1, detainees received cloths that contained chlorhexidine gluconate (CHG) to clean their entire skin surface 3 times per week for 6 months; group 2 received identical cloths containing only water; and group 3 received no skin treatment. During the study, all newly arrived detainees were invited to enroll. Nares and hand cultures were obtained at baseline and from all current enrollees at 2 and 6 months.
  
  
  RESULTS
  At baseline, S. aureus was isolated from 41.2% and MRSA from 8.0% (nares and/or hand) of 947 enrollees. The average participation rate was 47%. At 6 months, MRSA carriage was 10.0% in group 3 and 8.7% in group 1 tanks (estimated absolute risk reduction [95% confidence interval (CI)], 1.4% [-4.8% to 7.1%]; P = .655). At 6 months, carriage of any S. aureus was 51.1% in group 3, 40.7% in group 1 (absolute risk reduction [95% CI], 10.4% [0.01%-20.1%]; P = .047), and 42.8% (absolute risk reduction [95% CI], 8.3% [-1.4% to 18.0%]; P = .099) in group 2.
  
  
  CONCLUSIONS
  Skin cleaning with CHG for 6 months in detainees, compared with no intervention, significantly decreased carriage of S. aureus, and use of water cloths produced a nonsignificant but similar decrease. A nonsignificant decrease in MRSA carriage was found with CHG cloth use.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier NCT00785200.
authors.affiliation: Department of Medicine, University of Chicago, Chicago, Illinois.
authors.forename: Michael Z
authors.initials: MZ
authors.lastname: David
authors.forename: Jane D
authors.initials: JD
authors.lastname: Siegel
authors.forename: Janet
authors.initials: J
authors.lastname: Henderson
authors.forename: Greg
authors.initials: G
authors.lastname: Leos
authors.forename: Kaming
authors.initials: K
authors.lastname: Lo
authors.forename: Jerry
authors.initials: J
authors.lastname: Iwuora
authors.forename: Esmaeil
authors.initials: E
authors.lastname: Porsa
authors.forename: L Philip
authors.initials: LP
authors.lastname: Schumm
authors.forename: Susan
authors.initials: S
authors.lastname: Boyle-Vavra
authors.forename: Robert S
authors.initials: RS
authors.lastname: Daum
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002353:Carrier State / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D002710:Chlorhexidine / Q000627:therapeutic use*; D003020:Clothing; D004203:Disinfection / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D011330:Prisons; D012867:Skin / Q000382:microbiology; D013203:Staphylococcal Infections / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine