The REDUCE MRSA trial was published in today’s New England Journal of Medicine and took place in two stages from 2009-2011. A multidisciplinary team from the University of California, Irvine, Harvard Pilgrim Health Care Institute, Hospital Corporation of America (HCA) and the Centers for Disease Control and Prevention (CDC) carried out the study. The study was funded by Agency for Healthcare Research and Quality (AHRQ) with contributions from HCA and CDC. See below for quotes from the multidisciplinary team:
“CDC invested in these advances in order to protect patients from deadly drug-resistant infections. We need to turn science into practical action for clinicians and hospitals. CDC is working to determine how the findings should inform CDC infection prevention recommendations.” — Dr. Tom Frieden, M.D., M.P.H., CDC Director
“This study demonstrates what can be accomplished for patient safety when we create the right partnerships. This unique collaboration between public health scientists, academic investigators, and private hospitals allowed us to take novel infection prevention strategies to patients’ bedside. With these critical partnerships, we can better protect patients and make healthcare safer.” – John Jernigan, M.D., director of CDC’s Office of Prevention Research and Evaluation and head of CDC’s Prevention Epicenters Program.
“Patients in the ICU are already very sick, and the last thing they need to deal with is a preventable infection. This research has the potential to influence clinical practice significantly and create a safer environment where patients can heal without harm.” — Carolyn M. Clancy, M.D., Agency for Healthcare Research and Quality (AHRQ) Director
“This study helps answer a long-standing debate in the medical field about whether we should tailor our efforts to prevent infection to specific pathogens, such as MRSA, or whether we should identify a high-risk patient group and give them all special treatment to prevent infection. The universal decolonization strategy was the most effective and the easiest to implement. It eliminates the need for screening ICU patients for MRSA.” — Susan Huang, M.D., M.P.H., lead author and Associate Professor at the University of California Irvine School of Medicine and Medical Director of Epidemiology and Infection Prevention at UC Irvine Health.
“This unprecedented partnership has yielded information that not only makes preventing MRSA and other serious infections simpler and more effective, it sets a new standard for responsible infection prevention.” — Jonathan B. Perlin, MD, President, Clinical and Physician Services Group and Chief Medical Officer of HCA.
“This new study underscores the potential to create a learning health system, one that develops important insights by integrating carefully designed assessment into routine medical care. The combination of committed clinical and research teams with sophisticated electronic health records made these improvements possible — Richard Platt, M.D., M.S., the study’s senior author and Chair of the Harvard Medical School Department of Population Medicine, at the Harvard Pilgrim Health Care Institute in Boston.
“The strategy that proved to be most effective was perhaps the most straightforward: All patients were bathed daily with chlorhexidine antiseptic soap for the duration of their ICU stay and all received mupirocin antibiotic ointment applied in the nose for five days. This approach proved to be more effective than screening intensive care unit (ICU) patients for the bacteria and then focusing on those identified as carriers.” — Mary Hayden, M.D. associate professor of infectious diseases and pathology at Rush University Medical Center, and one of the co-authors of the study.
“In ICUs, these infections are generally caused by increasingly antibiotic-resistant bacteria that for most people live harmlessly on the skin or, particularly in the case of MRSA, in the nose. These are often preventable infections that can cause serious complications for patients. These results are critical when assessing whether other measures, either targeted or universal, would have greater impact.” — Robert Weinstein, M.D., a co-author of the study. He is professor of medicine at Rush University, and chair of the Department of Medicine of John H. Stroger, Jr. Hospital of Cook County.
“The results of this study are very important. The risks of acquiring healthcare-associated infections and multi-drug resistant organisms among critically ill patients remains a significant challenge. This study demonstrates new and cost effective methods to protect patients and improve outcomes in ICUs.” — co-author Victoria Fraser, MD, chairman of the Department of Medicine at Washington University School of Medicine in St. Louis.
See the entire study in NEJM: http://www.nejm.org/doi/full/10.1056/NEJMoa1207290
Click here to read a commentary by study authors Drs. Richard Platt, Jon Perlin, and Susan Huang on the implications of the REDUCE MRSA trial for a learning health system: www.iom.edu/winforlhs
Read an editorial in NEJM on the REDUCE MRSA trial: http://www.nejm.org/doi/full/10.1056/NEJMe1304831