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

Categories: Antimicrobial Resistance, Healthcare-associated infections, MRSA

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.

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Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this blog is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

  1. September 4, 2014 at 12:16 pm ET  -   Tina Euresti

    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.

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  2. May 23, 2011 at 3:10 pm ET  -   Sara McCloskey

    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.

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  3. May 8, 2011 at 5:28 am ET  -   Dane

    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.

    Dane

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