Enhanced ICU cleaning lowers MRSA rates

The risk of methicillin-resistant staphylococcus aureus (MRSA) infection among patients in intensive care units (ICUs) was sharply reduced through enhanced cleaning practices following the departure of prior patients with MRSA in those rooms, a new study finds.

Researchers at the University of California Irvine School of Medicine and colleagues reviewed infection rates among patients admitted to 10 ICUs--including medical, cardiac, burn/trauma, general surgery, cardiac surgery, thoracic surgery and neurosurgery units--at a 750-bed academic medical center both before and after the enhanced cleaning program.

During a 20-month period, the intervention included targeted feedback using black-light markers, changing how the disinfectant was applied (from pouring from bottles onto cleaning cloths to immersing cloths in buckets), and increasing education regarding the importance of repeated bucket immersion during cleaning, the researchers report in the latest Archives of Internal Medicine.

The rate of MRSA infections among patients in rooms previously occupied by patients with MRSA dropped from 3 percent (305 of 10,151 patients) to 1.5 percent (182 of 11,849) after introduction of the intensified cleaning program. In addition, rates of vancomycin-resistant enterococci (VRE) infection fell as well--from 3 percent (314 of 10,349) to 2.2 percent (256 of 11,871).

Environmental contamination with multidrug-resistant organisms may facilitate the spread of health care-associated infections elsewhere in the hospital, but this is an important issue to recognize in the ICUs where patients are at a much higher risk of infection due to co-exisiting illnesses, wounds, and the use of medical devices, the researchers note.

For more details:
- see the Archives of Internal Medicine abstract
- read the Becker's ASC Review article

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