The Checklist to Prevent MRSA Surgical Site Infections study is an interventional trial recruiting veteran patients who are undergoing or have undergone cardiac surgery or total joint arthroplasty.
The Department of Veteran Affairs has previously implemented the VA MRSA Prevention Initiative, which successfully reduced patient-to-patient MRSA transmission; however, this initiative does not prevent most MRSA surgical site infections, which are spread differently. The VA has developed a new checklist which will be tested in this study aimed at reducing MRSA surgical site infections (SSIs), and will be implemented at 10 VA medical centers.
Inclusion criteria include patients on VA databases who underwent cardiac surgery or total joint arthroplasty at VA centers within an 8-year stretch – 5 years prior to intervention and 3 years after intervention. Patients will be excluded if they have endocarditis, have an infection prior to surgery, undergo cardiac transplants or procedures performed using a percutaneous or thoracotomy approach, undergo hip or knee revisions, or have documented allergies to mupirocin.
The primary outcome measure is superficial and deep/organ space MRSA infections within 90 days of operation. Secondary outcome measures include superficial and deep/organ space MRSA infections within 1 year of operation, presurgical bundle and individual bundle components compliance for 30 days prior to operation, length of postoperative stay, all-cause mortality 1 year after surgery, readmission within 90 days of surgery, and mupirocin and chlorhexidine resistance 30 days presurgery to 90 days postsurgery.
The study will end in April 2019. More than 10,000 people are expected to be included in the final analysis.
Find more information on the study page at Clinicaltrials.gov .