St. Louis Staphylococcus aureus Reduction Study (StL StaRS)

Staphylococcus aureus, also known as “Staph” is a bacterium or germ that is commonly found on the skin or in the nose of approximately one third of normal, healthy people. In the last several years, St. Louis has experienced and increase in the number of Staph infections that are resistant to the usual antibiotics used to treat skin and soft tissue infections. People with the resistant Staph germ living in their nose or on their skin may be at a greater risk to develop future skin infections. We cannot predict who will get a recurrent Staph infection.

The St. Louis Staphylococcus aureus Reduction Study (StL StaRS) researches which people are likely to develop a recurrent Staph infection and how to prevent this from happening. Specifically, our study is aims to find methods to eliminate the Staph germ from the skin or nose.

Who is eligible to participate?

All patients greater than six months of age presenting to St. Louis Children’s Hospital or Barnes Jewish Hospital with an abscess caused by Staph and has the Staph germ living on the skin or in the nose.

Who is not eligible to participate?

• Patients with a permanent indwelling catheter or percutaneous medical device
• Patients with an infection at the site of a recent surgery or wound
• Patients on dialysis or who stayed in a long term care facility over the past year
• Patients who are pregnant

What will happen at the time of screening (during Emergency Room (ER) visit)?

• Verbal consent from the patient or participant’s parent or legal guardian to participate will be obtained
• Information about the participants’ colonization status will be collected by swabbing the nose, armpit and groin
• A short survey will be administered to gather information about the participant’s health, household, and activities

How long will the participant be followed in this study?

Screening visit	Enrollment visit	1-month follow-up	4-month follow-up	6-month follow-up
During ER visit	Return visit	Return visit	Return visit	Phone call

Will I need to return to the hospital?

• After the screening visit, if the Staph germ is found living on the skin or in the nose, participants will return to the St. Louis Children’s Hospital or Barnes Jewish Hospital for an enrollment visit.
• After the enrollment visit, participants will return to St. Louis Children’s Hospital or Barnes Jewish Hospital for a one month and four month follow-up
• All participants will be compensated $20 for each visit for their time and travel
• The 6 month survey will be administered by telephone

What will happen at the time of enrollment?

• Written consent from the patient or participant’s parent or legal guardian to participate will be provided
• A detailed survey will be administered
• Participants in our study will randomized in order to receive one of four decolonization regimens. These measure will be used for five days:
  1. Hygiene and education information about Staph
  2. Hygiene and education information and mupirocin ointment
  3. Hygiene and education information, mupirocin ointment, and chlorhexidine
  4. Hygiene and education information, mupirocin, and dilute bleach baths

What will happen at the one month and four month follow-up visits?

• Repeat swabbing of the nose, armpit, and groin to collect colonization status results
• A short survey will be administered about any recurring Staph infections

Again, the StL StaRS Study is studying measures to help eliminate the Staph germ from living on the body with the goal of preventing future infections.