Extract

Background and study aims Healthcare-associated infections are an important problem in hospitals and much research has been carried out on the bacteria that cause healthcare-associated infections (e.g. methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile) and the measures to control them. More recently, organisms that are resistant to many antibiotics, such as multi-drug resistant Gram-negative bacilli (MDR GNB) and vancomcyin-resistant enterococci (VRE), have become a problem in hospitals and are now a focus of research. In contrast, there has been little or no research done about healthcare-associated infections in community settings such as nursing homes. However, many people living in nursing homes are at risk of infection with these bacteria because of their underlying medical condition, antibiotic treatment, and contact with hospital either as an outpatient or an inpatient. The aim of this study is to look at the frequency of these organisms at Addenbrooke’s hospital and in the nursing home. This involves collection of samples for laboratory testing in order to identify the organisms that cause healthcare-associated infections (e.g. MRSA, C. difficile, MDR GNB and VRE). Genetic fingerprinting (whole genome sequencing) of the bacteria is also performed in order to understand the movement of organisms between patients and between the hospital and community setting. Who can participate? All patients admitted to Addenbrooke’s hospital and residents in a nursing home in Cambridge during the study period. What does the study involve? In the hospital, samples for testing are collected when indicated as part of routine clinical care. In the nursing home, samples are taken up to once a week for the duration of the study. The samples include swabs from the patient’'s nose, throat, groin, and any open wounds or ulcers. Samples of urine are also collected (if there is a urinary catheter) and stool (faeces). If a stool sample is not available then a rectal (bottom) swab is collected. Some clinical information is also collected from medical records. There are no study-specific interventions and all patients receive routine clinical care. What are the possible benefits and risks of participating? There are no direct benefits to the participant for taking part in the study. However, the information obtained from the study may help future patients and reduce the risk of healthcare-associated infections. There are no risks to the participant from taking part in the study. Having the samples taken may be mildly uncomfortable but does not hurt. Where is the study run from? The study is being run by the Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge (UK). When is the study starting and how long is it expected to run for? October 2013 to October 2014 Who is funding the study? The Wellcome Trust and the Department of Health (UK) Who is the main contact? Professor Sharon Peacock [email protected]

Inclusion criteria

• Healthcare associated pathogens e.g. Methicillin resistant Staphylococcus aureus (MRSA), Clostridium difficile, multidrug resistant Gram negative bacteria (MDR GNB), vancomycin resistant enterococci (VRE)

Links

• isrctn
• ictrp