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Preventing MRSA in healthcare – Is there a silver bullet? (Part 2 of 3)

Posted on by CDC's Safe Healthcare Blog
Martin Evans, MD
Martin Evans, MD

Author: Martin Evans, MD
Director of the VHA MRSA/MDRO Program

MRSA hospital-acquired infections (HAIs) cause increased suffering, the need for increased procedures, treatments, and time in the hospital, and sometimes an increased risk of death among patients. Beginning in 2002, staff working at the VA Pittsburgh Healthcare system successfully brought down MRSA HAIs using a “bundle” of infection control strategies. In 2007, VA leadership in Central Office, Washington, D.C. decided to have all 153 medical centers nationwide implement the bundle.

The “MRSA bundle” consisted of gently swabbing the nose of all patients admitted or transferred within the hospital to detect those carrying MRSA (known as universal active surveillance); preventing spread of the organism by placing those with MRSA in their own room away from those not carrying the organism; insisting that healthcare workers do hand hygiene and wear gloves and gowns when caring for the patient, and striving for a culture change where infection prevention and control becomes everyone’s responsibility.

From October 2007, when the MRSA Prevention Initiative was fully implemented nationwide though June 2010 (when we ended our analysis), patients spent more than 8 million days in VA hospitals, and more than 1.7 million swabs were done. This was 96% of all swabbing opportunities. VA healthcare providers brought MRSA HAIs down 62% from a two-year baseline in our 196 ICUs, and down 45% in our 428 non-ICUs. This was an estimated decrease of more than 1,000 MRSA HAIs in the ICUs over what would have been expected given the trend before 2007.

The thoroughness of active surveillance and the rapidity of results (sometimes available before patients were admitted from the Emergency Department), gave infection control personnel what they needed to keep the organism from spreading in their hospitals. The constant opportunities for active surveillance and need to act on the results probably kept infection control high on everyone’s list of priorities and drove a system-wide culture change, where healthcare workers began to appreciate infection prevention and control more and made the fight against MRSA HAIs their own mission. This had not occurred to such an extent before the MRSA Prevention Initiative even though programs were in place to emphasize hand hygiene, isolate properly, and prevent device-associated ICU infections.
Does your institution do active surveillance for MRSA?

**The views expressed are those of the author and do not necessarily represent those of the Department of Veterans Affairs.

Posted on by CDC's Safe Healthcare Blog

4 comments on “Preventing MRSA in healthcare – Is there a silver bullet? (Part 2 of 3)”

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    I have MRSA in my lumbar spine. On April 30, 2013. I prepared for surgery washed neck down with antiseptic soap for 5 days,including that morning that changed my life. I will be on antibiotic until April, 30, 2015. Plus there is NO assurance that it will not come back any time in the future with surgery I might need again to stabilize my vertebra s because this germ has eaten 2 away, I lost over 2 inches in height, My orthopedic surgeon and infectious disease specialist I see now every 2 months till April hope they will grow together without surgical metal so I can ride in a car without pain over every bump in the road, pain with everything I try to be a normal retired registered nurse that worked over 30 years helping others. So we’re so many breaks in healthcare from the doctors to housekeeping. My brain just woke up last month, I have been in a fog mentally. My lab tests still are not normal, indicates it is still fighting, Thank God. I was near death twice and had several blood culture positive for MRSA each time I required surgery (3 times) to remove dead tissue and pus. My last job was communicable disease coordinator of St Clair County in Michigan. I was on the hospital Infection Control Committee for three hospitals I never thought this would happen to me. I am angry because I should be traveling in a motor home across America, which we can’t because of medical costs and I can’t ride sitting up long enough. Plus I need to be close to my doctors. If there was a way to spread the importance of the basic hand washing and infection control practices to stop the spread of this disease!!!!

    Yes it is and it is i lost my father in 2003, and His case was very concerning to hospital and quality control. They lied and denied facts that i have found out from medical records and do to extreme unforeseen issues i have with out a doubt will say a conspiracy developed from hospital quality control and patient rights were so clearly wronged, and the health and safety of many other put at risk. I am still waiting to tell the truth and not for any other reason but to stop the lying and denying that this super bug is not just a problem aqurired from a hospital.

    56 white female,2008 had a kidney tumor removed(cancer)done laproscopicley,saved
    %95 of kidney,stent left in to be removed in 3wks.10 day’s after surgery ran a fever,
    became weak and disorintated brought to er tested for menigitis(neck hurt)with spinal.
    I was getting worse and neck started to swell.Rushed into surgery I had an abcess wrapped around c-3 to c-6 mrsa,osteomitlitis,in recovery room noticed I was quadroparlis rushed back in or to have a corpectomy a bridge and 4 screws,vented and some feeling came back and re-habed for 3months!! Remackably learned to walk again.
    About 8months later became very very weak thought mrsa was back did brain scan NOW THEY DIAGNOSED ME WITH MS.I can no longer work my husband is my soul care giver.Please someone tell my story and help me get well.

    There seems to be a problem worldwide with this, what can be done about it? Is the new plague going to be the MRSA super-bug.


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