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REDUCE MRSA: From Novel Idea to 74,000 Patients

Posted on by CDC's Safe Healthcare Blog
John Jernigan, M.D.
John Jernigan, M.D.

Author – John Jernigan, MD, MS
Director of CDC’s Office of Prevention Research and Evaluation and head of CDC’s Prevention Epicenters Program.

I am excited to announce the results of the REDUCE MRSA study which evaluated three current strategies for preventing methicillin-resistant Staphylococcus aureus (or MRSA) among adult critical care patients. This study – one of the largest to date on this subject, including over 74,000 patients — was recently published in the New England Journal of Medicine.   The study shows that using antimicrobial soap and ointment on all intensive-care unit (ICU) patients can reduce bloodstream infections caused by MRSA and other germs by 44 percent. 

The study is important for several reasons.  First, it answers questions about control of antimicrobial resistant organisms and other healthcare-associated infections, and offers a promising new approach to protecting patients and saving lives.  The study is also important because it demonstrates how creating the right partnerships can help us advance the science of patient safety.  This study was made possible through a unique collaborative partnership having its roots in the CDC Prevention Epicenters Program, a group of CDC-funded researchers who work together with CDC scientists to explore novel approaches to save patients from healthcare-associated infections.  Early research from these investigators and others conducted on a very small scale in single hospitals suggested that reducing germs on patient’s skin by bathing with a skin antiseptic would decrease transmission of pathogens and potentially prevent infections. To build on these results and to fill gaps in our knowledge about how best to prevent MRSA infection, CDC continued to partner with its Prevention Epicenter investigators, led by  University of California, Irvine,  and Harvard Pilgrim Health Care Institute, to design the REDUCE MRSA trial. We couldn’t do it alone, however.  The study design required us to partner with a large hospital network that was willing work with us to incorporate scientific method into the everyday delivery of care, essentially becoming a learning healthcare system, and Hospital Corporation of America (HCA)  accepted the invitation to participate. Subsequently, we approached the Agency for Healthcare Research and Quality to provide funds for the study, and our partnership was complete.

The result is a major advance in science, good news for patients, and potentially a model for how to advance the science of patient safety even further.   Taking a novel hypothesis about how to better protect patients, and moving it along a path that began with small scale tests in a single hospital units and led all the way to the bedside of  74,000 patients was a challenging task.  But identifying a novel approach that can reduce bloodstream infections by 44 percent illustrates the journey was well worth it.

The CDC Prevention Epicenters Program continues to work with its partners to move new hypotheses down new paths towards the goal of making patients safer.

Posted on by CDC's Safe Healthcare Blog

6 comments on “REDUCE MRSA: From Novel Idea to 74,000 Patients”

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    There is a proven protocol that heals MRSA. Two five minute applications one hour apart
    of chlorine dioxide gas. If you use a glass container ,you can actually see it fall into pieces as it heals. The medical profession fails to accept this finding. One can only guess as to why.

    I agree that it is important to consider unintended consequences for any novel intervention. As the authors state in the paper itself, it is possible that widespread use of chlorhexidine and mupirocin could engender resistance, thereby limiting the effectiveness of these agents in the long term. It will therefore be important for surveillance programs to monitor for the emergence of mupirocin and chlorhexidine resistance if this approach is used widely. CDC will carefully weigh these potential concerns against the benefits in the process of determining how the findings of the study might inform CDC infection prevention recommendations.

    There have been concerns expressed among our ID physicians and others about Mupirocin resistance, and whether we are “setting ourselves up” for increasing resistance should the decolonization of ICU patients be adopted on a widespread basis. Please respond to that concern.

    Hello! I send you my thanks for your great contribution to the science, for all your help that you provide worldwide,and special thanks to to all employees of your medical organization CDC for your invaluable contribution, you for your concern! I would very much like to you to be with us and in Ukraine! Regards Max! city ​​of Chernigov, Ukraine

    Environmental contamination of S. aureus as well as Listeria monocytogenes has been a problem with food processing plants for many years. Yes, good GMP controls for handwashing are essential, but we have also found that environmental controls to reduce the niche areas in the facility are important as well. Have used Lactobacillus saki and acidopholus for the elimination of these niche areas in the facility. Yes cleaning is essential, but having the correct microflora in the building assists in these areas especially in areas where the niche exists.

    Very helpful article and research, keep it up guys as we use the research in clean room food environments!

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