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CompletedNCT01105767Updated Feb 3, 2023Results posted

Methicillin-resistant Staphylococcus Aureus (MRSA) Skin and Soft Tissue Infection (SSTI) Prevention in Military Trainees

An interventional study of Chlorhexidine gluconate and Supplemental training, education and hygiene in Staphylococcus Aureus, MRSA Skin Infections and Staphylococcal Skin Infections, sponsored by Henry M. Jackson Foundation for the Advancement of Military Medicine. Completed at 1 site in United States. Open to male participants aged 18 Years to 42 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-02-03.

Primary conditionStaphylococcal Skin InfectionsRegistry: Staphylococcal InfectionsReclassifiedWhy we changed it
Registry
Staphylococcal Infections — the first condition term the registry derived for this study.
ClinicalTrials.gg
Staphylococcal Skin Infections
Why
  1. The study's listed conditions name Staphylococcal Skin Infections, a narrower term within Staphylococcal Infections.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Henry M. Jackson Foundation for the Advancement of Military Medicine · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
30,209
Allocation
Randomized
Ages
18 Years to 42 Years
Sex
Male
01

Study summary

This cluster-randomized prospective study will evaluate the effect of hygiene-based intervention strategies on the incidence of overall SSTI and MRSA-associated SSTI among military trainees. The proposed interventions used singly or in combination include standardized training and education, and weekly chlorhexidine showers.

Read the detailed description

MRSA SSTIs have become endemic in congregate community settings where there is frequent close person-to-person contact, such as athletic teams, correctional facilities, and military training facilities. These infections interfere with the mission of training soldiers as they impair soldiers' ability to participate in required activities and successfully complete a training program. Hygiene-based prevention programs (e.g., hand washing, environmental disinfection, and community-based education) appear to be effective in stemming outbreaks of MRSA SSTIs and need to by systematical evaluated.

This cluster-randomized prospective study will evaluate the effect of hygiene-based intervention strategies on the incidence of overall SSTI and MRSA-associated SSTI among military trainees. The study population will be drawn from six training battalions, each consisting of an average of six companies. Each company is composed of four platoons consisting of approximately 50 trainees. Training battalions are the unit of randomization in this study and sub-clusters (platoons within companies) within each battalion will receive the same hygiene-based intervention assigned to that battalion at study start. During the proposed 20-month evaluation period, five cycles of platoons (approximately 14 weeks per cycle) will enter and exit training activities. In total, the study population will be comprised of approximately 36,000 trainees observed over a 20-month period. Each of the six battalions will receive an in-processing preventive medicine briefing augmented with MRSA prevention information based on U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM) and Centers for Disease Control and Prevention (CDC) recommendations. Additionally, trainees who seek medical care for a SSTI will receive standardized care at a SSTI clinic applying uniform practice guidance. Four of the battalions will also receive supplemental SSTI education for trainees and drill sergeants, including standardized guidance on SSTI surveillance (e.g., skin inspection) for drill sergeants; trainees will be instructed to take a 10 minute shower with soap every Sunday while in garrison; and will be issued a personal first aid kit. Two of these four battalions will be offered chlorhexidine antiseptic body wash to use during the Sunday shower. Endpoints of the evaluation (i.e., incident SSTIs among military trainees) will be captured through clinical record review at the completion of training.

02

Conditions studied

  • Staphylococcus Aureus
  • MRSA Skin Infections
  • Staphylococcal Skin Infections

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Keywords

  • Staphylococcus aureus
  • MRSA Skin Infection
  • Staphylococcal Skin Infections
  • Chlorhexidine gluconate
03

In context

Staphylococcal Skin Infections Reclassified

30 studies on the registry are indexed under Staphylococcal Skin Infections; none are open to participants now.

This study's enrollment of 30,209 is above the median of 227 across 28 interventional studies indexed under Staphylococcal Skin Infections.

Browse Staphylococcal Skin Infections studies →

Lead sponsor

Henry M. Jackson Foundation for the Advancement of Military Medicine is the lead sponsor of 86 studies on the registry; 18 are open to participants now.

Of its 7 completed or terminated interventional studies of FDA-regulated products, 2 (29%) have results posted.

Compared within Staphylococcal Skin Infections, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Staphylococcal Infections. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years to 42 Years
Sexes eligible
Male
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Trainees assigned to one of the six selected training battalions
  • Trainees who present with an SSTI at the clinic or the hospital
  • Provide

Exclusion criteria

Exclusion Criteria:

  • Fails to meet inclusion criteria
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Factorial assignment
Masking
None (open label)
Enrollment
30,209 participants (actual)

Study arms

  • No intervention
    Group 1 Standard

    Trainees received a preventive medicine briefing augmented with SSTI and MRSA SSTI prevention information and personal hygiene instructions. Trainees seeking medical care for an SSTI received standardized SSTI care (e.g., antimicrobial therapy, wound management, patient education) at the Troop Medical Clinic. High-touch common surfaces within the battalion areas were cleaned with standard Environmental Protection Agency-registered disinfectants.

  • Active comparator
    Group 2 Enhanced Standard

    Trainees received the components of the Standard group as well as supplemental training, education and hygiene. They were instructed to take an additional 10-minute shower with soap and a wash cloth every week. They were also issued a first aid kit. Supplemental SSTI education for trainees and drill sergeants was also provided (e.g., pocket cards, posters). Drill sergeants received briefings on SSTI and skin inspection/minor wound care.

    Other: Supplemental training, education and hygiene

  • Active comparator
    Group 3 Chlorhexidine

    Trainees received the components of the Standard and Enhanced Standard groups and were offered chlorhexidine body wash (4% chlorhexidine gluconate, Hibiclens®, Mӧlnlycke Heath Care, Norcross, Georgia) to use with a wash cloth after using their personal soap for the additional once-weekly shower. Trainees were provided with verbal and written/graphic instructions for use.

    Drug: Chlorhexidine gluconate · Other: Supplemental training, education and hygiene

Interventions

  • Self applied chlorhexidine body wash (4% chlorhexidine gluconate, Hibiclens®, Mӧlnlycke Heath Care, Norcross, Georgia) once a week to wash/cover the body (except the face and genitalia).

  • OtherSupplemental training, education and hygiene

    Supplemental SSTI education for trainees and drill sergeants included pocket cards and posters. Drill sergeants received briefings on SSTI and skin inspection/minor wound care. Trainees were instructed to take an additional 10-minute shower with soap and a wash cloth every week. They were also issued a first aid kit.

06

What researchers measure

Primary outcomes

  1. Incidence of Skin and Soft Tissue Infection (SSTI)

    Time frame: At the end of the 20 month study

  2. Incidence of Methicillin-resistant Staphylococcus Aureus (MRSA)-Associated SSTI

    Time frame: At the end of the 20 month study

07

Results

Posted Nov 4, 2014

Participant flow

Participant flow — Overall Study
MilestoneGroup 1 StandardGroup 2 Enhanced StandardGroup 3 Chlorhexidine
Started93151086410030
Completed815592508846
Not completed116016141184
Withdrew: Lost to follow-up116016141184

Outcome measures

PrimaryIncidence of Skin and Soft Tissue Infection (SSTI)
Time frame:
At the end of the 20 month study
Reported as:
Number · participants
Incidence of Skin and Soft Tissue Infection (SSTI)
participantsGroup 1 StandardGroup 2 Enhanced StandardGroup 3 Chlorhexidine
Incidence of Skin and Soft Tissue Infection (SSTI)303439461
PrimaryIncidence of Methicillin-resistant Staphylococcus Aureus (MRSA)-Associated SSTI
Time frame:
At the end of the 20 month study
Reported as:
Number · participants
Incidence of Methicillin-resistant Staphylococcus Aureus (MRSA)-Associated SSTI
participantsGroup 1 StandardGroup 2 Enhanced StandardGroup 3 Chlorhexidine
Incidence of Methicillin-resistant Staphylococcus Aureus (MRSA)-Associated SSTI8613595

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Group 1 Standard—0/9,315 (0%)0/9,315 (0%)
Group 2 Enhanced Standard—0/10,864 (0%)0/10,864 (0%)
Group 3 Chlorhexidine—0/10,030 (0%)4/10,030 (0%)
Most frequent other events
Most frequent other events
EventGroup 1 StandardGroup 2 Enhanced StandardGroup 3 Chlorhexidine
Dermatitis due to soapSkin and subcutaneous tissue disorders0/93150/108644/10030

Baseline characteristics

Participants that developed SSTI.

Age, Continuous
Age, Continuous(years)Group 1 StandardGroup 2 Enhanced StandardGroup 3 ChlorhexidineTotal
Mean20.4 ± 3.120.3 ± 3.220.3 ± 2.920.3 ± 3.0
Sex: Female, Male
Sex: Female, Male(Participants)Group 1 StandardGroup 2 Enhanced StandardGroup 3 ChlorhexidineTotal
Female0000
Male3034394611203
Race/Ethnicity, Customized
Race/Ethnicity, Customized(participants)Group 1 StandardGroup 2 Enhanced StandardGroup 3 ChlorhexidineTotal
White, non-Hispanic92167172431
Hispanic13241855
Black, non-Hispanic77418
Other, non-Hispanic58518
Unknown186233262681
08

Study locations

1 site
  • Usa Meddac Mach
    Columbus, Georgia 31905, United States
09

References and documents

Publications

  • Jefferson T, Del Mar CB, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA, van Driel ML, Jones MA, Thorning S, Beller EM, Clark J, Hoffmann TC, Glasziou PP, Conly JM. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2020 Nov 20;11(11):CD006207. doi: 10.1002/14651858.CD006207.pub5. PubMed 33215698 ↗
  • Johnson RC, Ellis MW, Schlett CD, Millar EV, LaBreck PT, Mor D, Elassal EM, Lanier JB, Redden CL, Cui T, Teneza-Mora N, Bishop DK, Hall ER, Bishop-Lilly KA, Merrell DS. Bacterial Etiology and Risk Factors Associated with Cellulitis and Purulent Skin Abscesses in Military Trainees. PLoS One. 2016 Oct 25;11(10):e0165491. doi: 10.1371/journal.pone.0165491. eCollection 2016. PubMed 27780238 ↗
  • Millar EV, Schlett CD, Law NN, Chen WJ, D'Onofrio MJ, Bennett JW, Tribble DR, Ellis MW. Reduction in Acute Respiratory Infection Among Military Trainees: Secondary Effects of a Hygiene-Based Cluster-Randomized Trial for Skin and Soft-Tissue Infection Prevention. Infect Control Hosp Epidemiol. 2016 Sep;37(9):1118-20. doi: 10.1017/ice.2016.154. Epub 2016 Jul 8. No abstract available. PubMed 27387422 ↗
  • D'Onofrio MJ, Schlett CD, Millar EV, Cui T, Lanier JB, Law NN, Tribble DR, Ellis MW. Reduction in acute gastroenteritis among military trainees: secondary effects of a hygiene-based cluster-randomized trial for skin and soft tissue infection prevention. Infect Control Hosp Epidemiol. 2015 Mar;36(3):358-60. doi: 10.1017/ice.2014.65. PubMed 25695181 ↗
  • Millar EV, Chen WJ, Schlett CD, Cui T, Crawford KB, Lanier JB, Tribble DR, Ellis MW. Frequent use of chlorhexidine-based body wash associated with a reduction in methicillin-resistant Staphylococcus aureus nasal colonization among military trainees. Antimicrob Agents Chemother. 2015 Feb;59(2):943-9. doi: 10.1128/AAC.03993-14. Epub 2014 Nov 24. PubMed 25421482 ↗
  • Ellis MW, Schlett CD, Millar EV, Crawford KB, Cui T, Lanier JB, Tribble DR. Prevalence of nasal colonization and strain concordance in patients with community-associated Staphylococcus aureus skin and soft-tissue infections. Infect Control Hosp Epidemiol. 2014 Oct;35(10):1251-6. doi: 10.1086/678060. Epub 2014 Aug 19. PubMed 25203178 ↗
  • Ellis MW, Schlett CD, Millar EV, Wilkins KJ, Crawford KB, Morrison-Rodriguez SM, Pacha LA, Gorwitz RJ, Lanier JB, Tribble DR. Hygiene strategies to prevent methicillin-resistant Staphylococcus aureus skin and soft tissue infections: a cluster-randomized controlled trial among high-risk military trainees. Clin Infect Dis. 2014 Jun;58(11):1540-8. doi: 10.1093/cid/ciu166. Epub 2014 Mar 14. PubMed 24633684 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 3, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01105767
Lead sponsor
Henry M. Jackson Foundation for the Advancement of Military Medicine
Responsible party
Sponsor
First posted
Apr 16, 2010
Start date
May 2010
Primary completion
Jan 2012
Completion
Jan 2012
Results posted
Nov 4, 2014
Last update
Feb 3, 2023

Study contacts

Michael Ellis, MD
principal investigator · Uniformed Services University of the Health Sciences

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Chlorhexidine gluconate

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