A randomized controlled trial of tea tree oil (5%) body wash versus standard body wash to prevent colonization with methicillin-resistant Staphylococcus aureus (MRSA) in critically ill adults: research protocol

Background
Over the past ten years MRSA has become endemic in hospitals and is associated with increased healthcare costs. Critically ill patients are most at risk, in part because of the number of invasive therapies that they require in the intensive care unit (ICU). Washing with 5% tea tree oil (TTO) has been shown to be effective in removing MRSA on the skin. However, to date, no trials have evaluated the potential of TTO body wash to prevent MRSA colonization or infection. In addition, detecting MRSA by usual culture methods is slow. A faster method using a PCR assay has been developed in the laboratory, but requires evaluation in a large number of patients.

Methods/Design
This study protocol describes the design of a multicentre, phase II/III prospective open-label randomized controlled clinical trial to evaluate whether a concentration of 5% TTO is effective in preventing MRSA colonization in comparison with a standard body wash (Johnsons Baby Softwash) in the ICU. In addition we will evaluate the cost-effectiveness of TTO body wash and assess the effectiveness of the PCR assay in detecting MRSA in critically ill patients. On admission to intensive care, swabs from the nose and groin will be taken to screen for MRSA as per current practice. Patients will be randomly assigned to be washed with the standard body wash or TTO body wash. On discharge from the unit, swabs will be taken again to identify whether there is a difference in MRSA colonization between the two groups.

Discussion
If TTO body wash is found to be effective, widespread implementation of such a simple colonization prevention tool has the potential to impact on patient outcomes, healthcare resource use and patient confidence both nationally and internationally.

Trial Registration
[ISRCTN65190967]

The main-sequence rotation-colour relation in the Coma Berenices open cluster

We present the results of a photometric survey of rotation rates in the Coma Berenices (Melotte 111) open cluster, using data obtained as part of the SuperWASP exoplanetary transit-search programme. The goal of the Coma survey was to measure precise rotation periods for main-sequence F, G and K dwarfs in this intermediate-age (~600 Myr) cluster, and to determine the extent to which magnetic braking has caused the stellar spin periods to converge. We find a tight, almost linear relationship between rotation period and J - K colour with an rms scatter of only 2 per cent. The relation is similar to that seen among F, G and K stars in the Hyades. Such strong convergence can only be explained if angular momentum is not at present being transferred from a reservoir in the deep stellar interiors to the surface layers. We conclude that the coupling time-scale for angular momentum transport from a rapidly spinning radiative core to the outer convective zone must be substantially shorter than the cluster age, and that from the age of Coma onwards stars rotate effectively as solid bodies. The existence of a tight relationship between stellar mass and rotation period at a given age supports the use of stellar rotation period as an age indicator in F, G and K stars of Hyades age and older. We demonstrate that individual stellar ages can be determined within the Coma population with an internal precision of the order of 9 per cent (rms), using a standard magnetic braking law in which rotation period increases with the square root of stellar age. We find that a slight modification to the magnetic-braking power law, P ~ t0.56, yields rotational and asteroseismological ages in good agreement for the Sun and other stars of solar age for which p-mode studies and photometric rotation periods have been published.