Methodologic considerations of household-level methicillin-resistant Staphylococcus aureus decolonization among persons living with HIV

Jason E. Farley, Laura E. Starbird, Jill Anderson, Nancy A. Perrin, Kelly Lowensen, Tracy Ross, Karen C. Carroll

Research output: Contribution to journalArticlepeer-review

Abstract

Background People living with HIV (PLWH) have a higher prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization and likelihood of recurrent infection than the general population. Simultaneously treating MRSA-colonized household members may improve success with MRSA decolonization strategies. This article describes a pilot trial testing household-level MRSA decolonization and documents methodologic and pragmatic challenges of this approach. Methods We conducted a randomized controlled trial of individual versus individual-plus-household MRSA decolonization to reduce recurrent MRSA. PLWH with a history of MRSA who are patients of an urban HIV clinic received a standard MRSA decolonization regimen. MRSA colonization at 6 months was the primary outcome. Results One hundred sixty-six patients were referred for MRSA screening; 77 (46%) enrolled. Of those, 28 (36%) were colonized with MRSA and identified risk factors consistent with the published literature. Eighteen were randomized and 13 households completed the study. Conclusions This is the first study to report on a household-level MRSA decolonization among PLWH. Challenges included provider referral, HIV stigma, confidentiality concerns over enrolling households, and dynamic living situations. Although simultaneous household MRSA decolonization may reduce recolonization, recruitment and retention challenges specific to PLWH limit the ability to conduct household-level research. Efforts to minimize these barriers are needed to inform evidence-based practice.

Original languageEnglish (US)
Pages (from-to)1074-1080
Number of pages7
JournalAmerican Journal of Infection Control
Volume45
Issue number10
DOIs
StatePublished - Oct 1 2017

Keywords

  • Clinical trial
  • Pilot
  • Social network

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Fingerprint

Dive into the research topics of 'Methodologic considerations of household-level methicillin-resistant Staphylococcus aureus decolonization among persons living with HIV'. Together they form a unique fingerprint.

Cite this