Staphylococcus Aureus InfectionPhase 4PAINTSNCT04210505
Nasal Decolonization of Dialysis Patients Noses
A Phase 4 study testing Povidone-Iodine Topical Ointment in people with Staphylococcus Aureus Infection, run by Marin L. Schweizer, PhD at 5 sites in United States.
Trial summary
Hemodialysis patients are at high-risk for infections, specifically Staphylococcus aureus infections. The investigators propose to 1) implement a novel intervention (nasal povidone-iodine at each hemodialysis session) to prevent S. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Staphylococcus Aureus Infection
- What is being tested?
- Povidone-Iodine Topical Ointment
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 302 participants
- Where
- 5 sitesUnited States
- Study dates
- 29 Sep 2020to 31 Jan 2024
- Phase
- Phase 4
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adult patients receiving outpatient chronic hemodialysis at one of the 16 study dialysis centers.
- Note: the unit of randomization is the dialysis center, not the individual patient
Who cannot join
- Patients receiving peritoneal dialysis or home hemodialysis Pregnant women Patients with known sensitivity or allergy to iodine (documented or verbalized) Patients with active bacterial infections Children < 18 years of age. Patients with infections at the beginning of the study will enter the study after antibiotic treatment is complete.
Trial locations and contacts
5 sites in 1 country.
5 sites in 1 country
United States5 sites
Emory Healthcare
Atlanta, Georgia, 30322
University of Illinois Chicago
Chicago, Illinois, 60612
University of Iowa
Iowa City, Iowa, 52242
University of Pennsylvania
Philadelphia, Pennsylvania, 19104
Washington University
St Louis, Missouri, 63110
About this study
Official title: Povidone-iodine to Stop Access-related Infections and Transmission of Staphylococcus Aureus (PAINTS)
Hemodialysis patients are at high-risk for infections, specifically Staphylococcus aureus infections. The investigators propose to 1) implement a novel intervention (nasal povidone-iodine at each hemodialysis session) to prevent S. aureus infections using a stepped-wedge cluster randomized trial, and 2) evaluate the feasibility and acceptability of this intervention. If successful, this intervention can be used among hemodialysis patients, and evaluated in other high-risk patient populations to prevent S. aureus infections.
Read the detailed description
The PAINTS study is a stepped-wedge cluster randomized trial that will compare standard care to an intervention that includes nasal povidone-iodine at each hemodialysis session to determine whether nasal povidone-iodine prevents infections. The nasal povidone-iodine will be donated by 3M. This formulation of nasal povidone-iodine was developed under the Tentative Final Monograph for Health-Care Antiseptic Drug Products 21 CFR Parts 333 and 369 (Docket # 75N-183H), Federal Register Volume 59, Number 116, Friday, June 17, 1994, Proposed Rules. However, the product need not be controlled like a pharmaceutical drug. The product may be stored and controlled similarly to an iodine or alcohol skin preparation product.
- Conditions
- Staphylococcus Aureus Infection
- Being tested
- Povidone-Iodine Topical Ointment, Standard Care
- Keywords
- Dialysis, povidone-iodine
- Medical subject headings
- Staphylococcal Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Povidone-Iodine Topical OintmentDrug
Intranasal povidone-iodine will be applied to the lower anterior nares (i.e. nostril) of patients undergoing hemodialysis before each session.
Standard CareOther
Control group will receive standard care as provided by the dialysis center
| Study group | Role | What they receive |
|---|---|---|
| Nasal Povidone-Iodine Decolonization Intervention | Experimental | Intranasal povidone-iodine (3M Skin and Nasal Antiseptic) will be applied to the patients' noses at each hemodialysis session. Receives: Drug: Povidone-Iodine Topical Ointment; Other: Standard Care |
| Concurrent Control | No intervention | Standard of Care. This will be usual care at each hemodialysis center. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of Staphylococcus aureus bloodstream infection
Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) definition: a Staphylococcus aureus positive blood specimen collected in the outpatient setting or within 1 calendar day after a hospital admission
Measured: Through study completion (up to 3 years)
Secondary outcomes (6)
Incidence of Staphylococcus aureus access related bloodstream infection (ARBSI)
Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) definition: a Staphylococcus aureus bloodstream infection with the suspected source reported as the vascular access or uncertain
Measured: Through study completion (up to 3 years)
Incidence of Staphylococcus aureus local access site infection
Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) definition: pus, redness or increased swelling at the vascular access site when an ARBSI is not present but with positive culture for Staphylococcus aureus
Measured: Through study completion (up to 3 years)
Incidence of Bloodstream infections by any pathogen
Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network definition: a positive blood specimen collected in the outpatient setting or within 1 calendar day after a hospital admission
Measured: Through study completion (up to 3 years)
Incidence of Access related bloodstream infection by any pathogen
Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network definition: a bloodstream infection with the suspected source reported as the vascular access or uncertain
Measured: Through study completion (up to 3 years)
Incidence of Local access site infection
Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) definition: pus, redness or increased swelling at the vascular access site when an ARBSI is not present
Measured: Through study completion (up to 3 years)
Incidence of Staphylococcus aureus bloodstream infection among patients who agreed to participate in intervention
Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network
Measured: Through study completion (up to 3 years)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Dec 2019
- Study start29 Sep 2020
- Primary completion31 Jan 2024 (estimated)
- Study completion31 Jan 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Staphylococcus Aureus InfectionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 302 participants (actual)
Sponsor and investigators
- Lead sponsor
- Marin L. Schweizer, PhD
- Sponsor type
- University, hospital or other
- Collaborators
- University of Pennsylvania, University of Illinois Chicago, Washington University School of Medicine, Emory Healthcare, Agency for Healthcare Research and Quality (AHRQ), 3M
- Responsible party
- Sponsor-investigator, Marin L. Schweizer, PhD, University of Iowa
- Investigators
- Marin L Schweizer, PhD, Principal investigator, University of Wisconsin, Madison
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04210505
- Sponsor's protocol ID
- Pending
- Other IDs
- 1R01HS026724
- Acronym
- PAINTS
- Status last verified
- Jun 2023
- First submitted
- 18 Dec 2019
- Last updated
- 28 Jun 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: The investigators will submit an electronic version of each peer-reviewed accepted manuscript to PubMed Central to be made publicly available within 12 months of publication. The investigators will respond to requests for restricted public health data sets and ensure responses follow appropriate processes, documentation, and approval.
Publications
Armstrong-Pavlik F, Racila AM, Ward M, Nair R, Tolomeo P, Kellogg J, Lindsey B, Herwaldt LA, Jacob JT, Vijayan A, Pegues D, Cobb J, Fraer M, Casey SB, Dukes KC, Hockett Sherlock S, Hopps M, Schweizer ML. Survey of hemodialysis patients' knowledge of their infection risk and acceptability of an intranasal decolonization intervention. Infect Control Hosp Epidemiol. 2026 Mar;47(3):252-256. doi: 10.1017/ice.2025.10386. Epub 2026 Feb 4.
PubMed 41635193Racila AM, O'Shea AMJ, Nair R, Dukes K, Herwaldt LA, Boyken L, Diekema D, Ward MA, Cobb J, Jacob J, Pegues D, Bleasdale S, Vijayan A, Mutneja A, Fraer M, O'Connell-Moore D, Tolomeo P, Mendez M, Jaworski E, Schweizer ML. Using nasal povidone-iodine to prevent bloodstream infections and transmission of Staphylococcus aureus among haemodialysis patients: a stepped-wedge cluster randomised control trial protocol. BMJ Open. 2021 Dec 3;11(12):e048830. doi: 10.1136/bmjopen-2021-048830.
PubMed 34862278
Study at a glance
From the registry record, last updated by the sponsor on 28 Jun 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Povidone-iodine to Stop Access-related Infections and Transmission of Staphylococcus Aureus (PAINTS)
- ClinicalTrials.gov ID
- NCT04210505
- Acronym / sponsor ID
- PAINTS / Pending
- Conditions
- Staphylococcus Aureus Infection
- Keywords
- Dialysis, povidone-iodine
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 302 participants (actual)
- Lead sponsor
- Marin L. Schweizer, PhDUniversity, hospital or other
- Collaborators
- University of Pennsylvania, University of Illinois Chicago, Washington University School of Medicine, Emory Healthcare, Agency for Healthcare Research and Quality (AHRQ), 3M
- Study start
- 29 Sep 2020 (actual)
- Primary completion
- 31 Jan 2024 (estimated)
- Study completion
- 31 Jan 2024 (estimated)
- First posted
- 24 Dec 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Hemodialysis patients are at high-risk for infections, specifically Staphylococcus aureus infections. The investigators propose to 1) implement a novel intervention (nasal povidone-iodine at each hemodialysis session) to prevent S. aureus infections using a stepped-wedge cluster randomized trial, and 2) evaluate the feasibility and acceptability of this intervention. If successful, this intervention can be used among hemodialysis patients, and evaluated in other high-risk patient populations to prevent S. aureus infections.
Detailed description
The PAINTS study is a stepped-wedge cluster randomized trial that will compare standard care to an intervention that includes nasal povidone-iodine at each hemodialysis session to determine whether nasal povidone-iodine prevents infections. The nasal povidone-iodine will be donated by 3M. This formulation of nasal povidone-iodine was developed under the Tentative Final Monograph for Health-Care Antiseptic Drug Products 21 CFR Parts 333 and 369 (Docket # 75N-183H), Federal Register Volume 59, Number 116, Friday, June 17, 1994, Proposed Rules. However, the product need not be controlled like a pharmaceutical drug. The product may be stored and controlled similarly to an iodine or alcohol skin preparation product.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Nasal Povidone-Iodine Decolonization Intervention | Experimental | Drug: Povidone-Iodine Topical Ointment, Other: Standard CareIntranasal povidone-iodine (3M Skin and Nasal Antiseptic) will be applied to the patients' noses at each hemodialysis session. |
| Concurrent Control | No intervention | –Standard of Care. This will be usual care at each hemodialysis center. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Adult patients receiving outpatient chronic hemodialysis at one of the 16 study dialysis centers.
- Note: the unit of randomization is the dialysis center, not the individual patient
Key exclusion criteria (1 listed)
- Patients receiving peritoneal dialysis or home hemodialysis Pregnant women Patients with known sensitivity or allergy to iodine (documented or verbalized) Patients with active bacterial infections Children < 18 years of age. Patients with infections at the beginning of the study will enter the study after antibiotic treatment is complete.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Povidone-Iodine Topical OintmentIntranasal povidone-iodine will be applied to the lower anterior nares (i.e. nostril) of patients undergoing hemodialysis before each session. | Drug | Nasal Povidone-Iodine Decolonization Intervention |
| Standard CareControl group will receive standard care as provided by the dialysis center | Other | Nasal Povidone-Iodine Decolonization Intervention |
Primary outcome
Incidence of Staphylococcus aureus bloodstream infection
Time frame: Through study completion (up to 3 years)
Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) definition: a Staphylococcus aureus positive blood specimen collected in the outpatient setting or within 1 calendar day after a hospital admission
6 secondary outcomes
Incidence of Staphylococcus aureus access related bloodstream infection (ARBSI)
Time frame: Through study completion (up to 3 years)
Incidence of Staphylococcus aureus local access site infection
Time frame: Through study completion (up to 3 years)
Incidence of Bloodstream infections by any pathogen
Time frame: Through study completion (up to 3 years)
Incidence of Access related bloodstream infection by any pathogen
Time frame: Through study completion (up to 3 years)
Incidence of Local access site infection
Time frame: Through study completion (up to 3 years)
Incidence of Staphylococcus aureus bloodstream infection among patients who agreed to participate in intervention
Time frame: Through study completion (up to 3 years)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Jun 2023.
- Derived from this study: PubMed 41635193Armstrong-Pavlik F, Racila AM, Ward M, Nair R, Tolomeo P, Kellogg J, Lindsey B, Herwaldt LA, Jacob JT, Vijayan A, Pegues D, Cobb J, Fraer M, Casey SB, Dukes KC, Hockett Sherlock S, Hopps M, Schweizer ML. Survey of hemodialysis patients' knowledge of their infection risk and acceptability of an intranasal decolonization intervention. Infect Control Hosp Epidemiol. 2026 Mar;47(3):252-256. doi: 10.1017/ice.2025.10386. Epub 2026 Feb 4.
- Derived from this study: PubMed 34862278Racila AM, O'Shea AMJ, Nair R, Dukes K, Herwaldt LA, Boyken L, Diekema D, Ward MA, Cobb J, Jacob J, Pegues D, Bleasdale S, Vijayan A, Mutneja A, Fraer M, O'Connell-Moore D, Tolomeo P, Mendez M, Jaworski E, Schweizer ML. Using nasal povidone-iodine to prevent bloodstream infections and transmission of Staphylococcus aureus among haemodialysis patients: a stepped-wedge cluster randomised control trial protocol. BMJ Open. 2021 Dec 3;11(12):e048830. doi: 10.1136/bmjopen-2021-048830.
- Individual participant dataSharing planned: Yes. The investigators will submit an electronic version of each peer-reviewed accepted manuscript to PubMed Central to be made publicly available within 12 months of publication. The investigators will respond to requests for restricted public health data sets and ensure responses follow appropriate processes, documentation, and approval.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Marin L Schweizer, PhD principal investigator
University of Wisconsin, Madison
5 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Povidone-Iodine Topical Ointment in people with Staphylococcus Aureus Infection, run by Marin L. Schweizer, PhD at 5 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 28 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 5 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Incidence of Staphylococcus aureus bloodstream infection (time frame: Through study completion (up to 3 years)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04210505, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jun 2023.