Five years after implementing a national initiative to reduce methicillin-resistant Staphylococcus aureus (MRSA) rates in Veterans Affairs (VA) medical centers, MRSA cases have continued to decline, according to a study in the November issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).
The MRSA Prevention Initiative, implemented in 2007, resulted in significant decreases in both the transmission (colonization with the organism) of MRSA (17 percent for intensive care units [ICUs] and 21 percent for non-ICUs) and healthcare-associated infection (HAI) rates within the hospitals (62 percent for ICUs, 45 percent for non-ICUs). In the two-year period following the first wave of the initiative (data previously published ), both MRSA transmissions and HAIs continued to decrease in non-ICU settings (declining an additional 13.7 percent and 44.8 percent, respectively), while holding steady in ICUs.
The MRSA Prevention Initiative utilizes a bundled approach that includes screening every patient for MRSA, use of gowns and gloves when caring for patients colonized or infected with MRSA, hand hygiene, and an institutional culture change focusing on individual responsibility for infection control. It also created the new position of MRSA Prevention Coordinator at each medical center.
"The analysis…shows that over the ensuing 24 months, MRSA transmission and MRSA HAI rates continued to decrease nationwide," state the authors. "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."
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that is resistant to many antibiotics and an important cause of illness and sometimes death. In medical facilities, MRSA causes life-threatening bloodstream infections, pneumonia and surgical site infections. In the community, most MRSA infections are skin infections.
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Jain R, Kralovic SM, Evans ME, Ambrose M, Simbartl LA, Obrosky DS, et al. Veterans Affairs initiative to prevent methicillin-resistant Staphylococcus aureus infections. N Engl J Med 2011;364:1419-30.