Five years after Veterans Affairs (VA) medical centers implemented a national initiative to reduce methicillin-resistant Staphylococcus aureus (MRSA), MRSA cases are on the decline, according to a soon-to-be released study in the November issue of the American Journal of Infection Control.
The VA established the MRSA Prevention Initiative in 2007 to prevent the spread of the bacteria that is resistant to antibiotics and often causes life-threatening bloodstream infections, pneumonia and surgical site infections in hospitals.
The initiative calls for the VA and its caregivers to:
Screen every patient for MRSA;
Use gowns and gloves when caring for patients colonized or infected with MRSA;
Follow hand-hygiene guidelines;
Create an institutional culture change focusing on individual responsibility for infection control; and
Establish an MRSA prevention coordinator position at each medical center.
Following the first wave of the initiative, medical centers reported a 17 percent decrease in the transmission of MRSA in intensive care units and 21 percent in non-ICUs. In addition, healthcare-associated infection (HAI) rates within the hospitals also dropped by 62 percent in ICUs and 45 percent in non-ICUs.
For the new study, researchers reexamined 24 months of data since the initial phase, from July 2010 through June 2012. During that time period, there were 2.3 million admissions to or transfers or discharges from VA ICUs and non-ICUs. They found both MRSA transmissions and HAIs continued to decrease in non-ICU settings an additional 13.7 percent and 44.8 percent, respectively, while holding steady in ICUs.
They also found:
The prevalence of patients carrying MRSA at admission decreased 5 percent;
Monthly transmission rates in ICUs and non-ICUs combined declined 12.1 percent; and
Monthly MRSA HAI rates in ICUs and non-ICUs combined declined 36.4 percent.
"The analysis…shows that over the ensuing 24 months, MRSA transmission and MRSA HAI rates continued to decrease nationwide," said lead author Martin E. Evans, M.D., of the VHA MRSA/MDRO program office of the Lexington (Ky.) VA Medical Center. "Detailed analysis showed that there were statistically significant declines in MRSA transmissions and MRSA HAIs in non-ICUs but not in the ICUs. The absence of statistically significant trends in the ICUs may be because MRSA transmission and MRSA HAI rates were low."
- here's the study announcement
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