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  • 1
    Online Resource
    Online Resource
    Clostridioides difficile infections complicating combat-injured patients from Iraq and Afghanistan
    Cambridge University Press (CUP) ; 2020
    In:  Infection Control & Hospital Epidemiology Vol. 41, No. 9 ( 2020-09), p. 1100-1102
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 41, No. 9 ( 2020-09), p. 1100-1102
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1017/ice.2020.299
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2020
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  • 2
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    Online Resource
    Chlorhexidine Does Not Select for Resistance in Staphylococcus aureus Isolates in a Community Setting
    Cambridge University Press (CUP) ; 2012
    In:  Infection Control & Hospital Epidemiology Vol. 33, No. 10 ( 2012-10), p. 1061-1063
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 33, No. 10 ( 2012-10), p. 1061-1063
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1086/667744
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2012
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  • 3
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    Online Resource
    Chlorhexidine-Impregnated Cloths to Prevent Skin and Soft-Tissue Infection in Marine Recruits: A Cluster-Randomized, Double-Blind, Controlled Effectiveness Trial
    Cambridge University Press (CUP) ; 2010
    In:  Infection Control & Hospital Epidemiology Vol. 31, No. 12 ( 2010-12), p. 1207-1215
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    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 31, No. 12 ( 2010-12), p. 1207-1215
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1086/657136
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2010
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  • 4
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    Online Resource
    Chlorhexidine Gluconate Reduces Transmission of Methicillin-Resistant Staphylococcus aureus USA300 among Marine Recruits
    Cambridge University Press (CUP) ; 2012
    In:  Infection Control & Hospital Epidemiology Vol. 33, No. 8 ( 2012-08), p. 809-816
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 33, No. 8 ( 2012-08), p. 809-816
    Abstract: Methicillin-resistant Staphylococcus 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.
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1086/666631
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2012
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  • 5
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    Online Resource
    USA300 Methicillin-Resistant Staphylococcus aureus Emerging as a Cause of Bloodstream Infections at Military Medical Centers
    Cambridge University Press (CUP) ; 2013
    In:  Infection Control & Hospital Epidemiology Vol. 34, No. 4 ( 2013-04), p. 393-399
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 34, No. 4 ( 2013-04), p. 393-399
    Abstract: USA300 methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of skin and soft-tissue infection (SSTI) in military personnel. USA300 MRSA has emerged as an important cause of healthcare-associated bloodstream infection (BSI) in metropolitan centers. Objective. To determine the prevalence, risk factors, and patient outcomes associated with USA300 MRSA BSI in military tertiary medical centers. Design. Retrospective case-control study. Patients. Patients admitted during the period 2001–2009 with MRSA BSI. Setting. Walter Reed Army Medical Center (Washington, DC) and National Naval Medical Center (Bethesda, MD) tertiary medical centers with 500 inpatient beds combined, which provide care to active duty service members and military beneficiaries. Methods. After identifying patients with MRSA BSI, we collected epidemiological data from electronic medical records and characterized bacterial isolates using pulsed-field gel electrophoresis (PFGE). Results. A total of 245 MRSA BSI cases were identified, and 151 isolates were available for analysis. Epidemiological characteristics for the 151 patients with available isolates included the following: mean age, 61 years; male sex, 70%; white race, 62%; and combat-wounded service members, 11%. The crude in-hospital mortality rate was 17%. PFGE demonstrated that 30 (20%) of 151 MRSA BSI cases with isolates available for analysis were due to USA300, and 27 (87%) of these 30 cases were healthcare-associated infection. USA300 was associated with a significantly increasing proportion of MRSA BSI when examined over sequential time periods: 2 (4%) of 51 isolates during 2001–2003, 9 (19%) of 47 isolates during 2004–2006, and 19 (36%) of 53 isolates during 2007–2009 ( P 〈 .001). Conclusion. USA300 MRSA is emerging as a cause of healthcare-associated BSI in tertiary military medical centers.
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1086/669866
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2013
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