Although community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasingly recognized in the U.S. and throughout the world, prevention and control methods for CA-MRSA have not been studied. We propose to: 1) determine the number of S. aureus (CA-MRSA and methicillin-susceptible S. aureus) colonized household members of CA-MRSA infected children < 6 years old; 2) quantify the development of S. aureus infections in S. aureus colonized persons over a one year period; 3) assess the effectiveness of enhanced education on personal hygiene and wound care in reducing S. aureus transmission; 4) assess the effectiveness of enhanced education on personal hygiene and wound care in reducing S. aureus infections; and 5) determine if knowledge_ attitudes, and practices (KAP) regarding personal hygiene and wound care are affected by enhanced education. CA-MRSA infected case-patients < 6 years of age will be identified through 12 sentinel hospital laboratories that report all cases of MRSA to the Minnesota Department of Healthper our Communicable Disease Reporting Rule. Consenting households will be randomized into a control or intervention arm. The control arm will receive standard education materials (i.e., MRSA fact sheet). The intervention arm will receive enhanced education including additional fact sheets on MRSA, personal hygiene, and wound care; verbal instructions; and an MRSA Intervention Kit containing triclosan-containing soap and alcohol-based hand rub. At enrollment, study participants will complete a KAP survey regarding S. aureus, MRSA, personal hygiene, and wound care and a nasal swab will be obtained; a second swab will be obtained 7-14 days later; 22-26 weeks following enrollment, a third nasal swab will be obtained and the KAP survey will be repeated; 12-13 months after enrollment participants will be interviewed regarding the incidence of S. aureus infections during the one year period following the case-patient's CA-MRSA culture. Medical records will be reviewed to validate patient !nterview information.
