Hospitals that cooperate on infection control fare better than hospitals acting alone

October 9, 2012

An individual hospital's infection control efforts have a ripple effect on the prevalence of a deadly and highly infectious bacterium in hospitals throughout its surrounding region, a multi-center research group led by the University of Pittsburgh demonstrated in a computer simulation-based study.

Methicillin-resistant Staphylococcus aureus, or MRSA, infections are better prevented when hospitals cooperate and coordinate their infection control procedures. Hospitals working alone do not achieve the same level of infection control, according to the results of the study published in the October issue of the journal Health Affairs.

"Unless they are associated financially or legally, hospitals often have their own separate infection control programs and procedures," said Bruce Lee, M.D., M.B.A., director of Pitt's Public Health and Computational and (PHICOR) group. "However, hospitals are rarely isolated islands and instead share patients extensively with other hospitals in their area, which can facilitate the spread of ."

Lee and his colleagues obtained real-world data from all 29 hospitals in , Calif., and developed a computer simulation to assess a procedure called "contact isolation" to limit MRSA transmission. The procedure involves testing all patients for MRSA upon admission to a hospital. When a patient tests positive, must wear gloves and gowns whenever entering that patient's room or interacting with that person.

The simulation explored scenarios in which different combinations of hospitals implemented contact isolation to varying degrees.

"The more that hospitals work together and coordinate infection control efforts, the more they all benefit," said Dr. Lee, also an associate professor of medicine, epidemiology and at Pitt's School of Medicine and Graduate School of Public Health. "For example, doubling the number of hospitals that adopt contact isolation can more than double their improvement in ."

The simulation also found that requiring contact isolation at one hospital not only decreased MRSA at that hospital as expected, but also did so in other nearby hospitals that had not implemented the intervention.

When the simulation was run with all the hospitals in Orange County implementing contact isolation simultaneously with a 75 percent compliance rate, MRSA prevalence decreased an additional 3.85 percent over what the hospitals could have achieved on their own. Long-term acute care facilities fared even better, with a 12.13 percent additional decrease.

The simulation relies extensively on data regarding infection rates, annual admissions, average patient length-of-stay, hospital transfers, readmissions, number of intensive care units and bed capacity at the Orange County hospitals.

MRSA is widely prevalent in U.S. hospitals. In 2006, the MRSA colonization rate, or detection of the bacteria on a patient's skin or soft tissue, was 12 per 1,000 inpatients. In 2010, the rate nearly quadrupled to 41 per 1,000 inpatients despite an overall decrease in the rates of MRSA infection.

The researchers had shown previously that hospitals in Orange County, which has a population of 3 million, are highly interconnected through patient transfers and readmission of patients to different hospitals after an intervening stay at home or elsewhere.

Some hospitals have started cooperating to control hospital-acquired infections. In California, the Safety Net Initiative is building a learning collaborative among California public hospitals to reduce such infections. The Pittsburgh Regional Health Initiative has successfully created a culture of change to improve overall patient safety. Similar programs in Iowa, Michigan, Nebraska, New York, South Dakota and Wisconsin also have successfully reduced -acquired infections.

Related Stories

Common themes emerge in hospitals' anti-MRSA efforts

August 11, 2011

Researchers from the Indiana University have identified common barriers and strategies for successfully implementing practice changes in Intensive Care Units (ICUs). The study, published in the August issue of Infection Control ...

Most California hospitals implementing infection control

March 17, 2012

(HealthDay) -- Most California hospitals implement some policies to improve infection control for multidrug-resistant organisms (MDRO), primarily methicillin-resistant Staphylococcus aureus (MRSA), but few policies are associated ...

Recommended for you

Experimental MERS vaccine shows promise in animal studies

July 28, 2015

A two-step regimen of experimental vaccines against Middle East respiratory syndrome (MERS) prompted immune responses in mice and rhesus macaques, report National Institutes of Health scientists who designed the vaccines. ...

Can social isolation fuel epidemics?

July 21, 2015

Conventional wisdom has it that the more people stay within their own social groups and avoid others, the less likely it is small disease outbreaks turn into full-blown epidemics. But the conventional wisdom is wrong, according ...

Lack of knowledge on animal disease leaves humans at risk

July 20, 2015

Researchers from the University of Sydney have painted the most detailed picture to date of major infectious diseases shared between wildlife and livestock, and found a huge gap in knowledge about diseases which could spread ...

IBD genetically similar in Europeans and non-Europeans

July 20, 2015

The first genetic study of inflammatory bowel disease (IBD) to include individuals from diverse populations has shown that the regions of the genome underlying the disease are consistent around the world. This study, conducted ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.