• The primary outcome measure will be eradication of S. aureus carriage 1 month after performing decolonization measures. [ Time Frame: 1 month after enrollment. ] [ Designated as safety issue: No ]
  

• Recurrence of CA-MRSA skin or soft tissue infection. [ Time Frame: 1, 3, 6, 9 and 12 months after enrollment. ] [ Designated as safety issue: No ]
  
• Eradication of S. aureus carriage after performing decolonization measures. [ Time Frame: 3, 6 and 12 months after enrollment ] [ Designated as safety issue: No ]
  
• Time to recolonization. [ Time Frame: 3, 6 and 12 months after enrollment. ] [ Designated as safety issue: No ]
  

Methicillin-resistant Staphylococcus aureus (MRSA) was once uniformly associated with hospital-acquired infections; however, MRSA strains have emerged that thrive outside the hospital environment, causing significant morbidity and mortality among immunocompetent individuals, leading to their designation as community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA).

CA-MRSA has become a major source of morbidity and mortality in our pediatric population. An important prerequisite for S. aureus infection may be nasal carriage of the organism. A variety of decolonization strategies have been used for infection prophylaxis, primarily in patients undergoing hemodialysis or surgery, with varying results. However, there are no published randomized eradication trials evaluating the decolonization and prevention of CA-MRSA infections in immunocompetent children in the outpatient setting. While the transmission of CA-MRSA within households has been reported, its contribution to recurrent CA-MRSA infection among household members is undetermined. We hypothesize that spread of CA-MRSA among household members leads to recolonization or failure of decolonization in children undergoing eradication efforts.

Specific Aim: In pediatric patients presenting with a MRSA skin or soft tissue infection, compare the effectiveness of decolonization measures performed by an entire household in comparison to measures directed at the index patient alone. We will conduct a randomized, controlled trial to test the hypothesis that decolonization measures performed by the entire household, specifically application of intranasal mupirocin ointment and bathing with chlorhexidine liquid soap, in addition to education and basic hygiene interventions, will be twice as effective in eradicating CA-MRSA carriage in the index patient than if the measures are performed only by the index patient.