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Scientists at the Virginia Commonwealth University Medical Center found a compliance with non-pathogen specific infection control practices such as hand hygiene, efforts to reduce device-related infections and chlorhexidine bathing, is successful for reducing rates of healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA). The findings were presented at the Fifth Decennial International Conference on Healthcare-Associated Infections.
In an effort to reduce MRSA rates, some states have mandated active surveillance programs for patients admitted to hospitals. However these programs remains controversial, with critics pointing to its expense, tying scarce infection prevention resources to one pathogen and the potential for adverse outcomes when patients who test positive are placed in isolation with reduced contact with healthcare personnel.
Beginning in 2004, the medical center instituted a series of non-pathogen specific initiatives to reduce HAIs including an increasingly aggressive hand hygiene program, a central line bundle, a ventilator bundle and chlorhexidine bathing of all adult ICU patients and a recommendation for bare below the elbows, along with compliance monitoring and feedback via unit-specific posters. Active surveillance cultures were not performed.
During this time, Michael Edmond, MD, MPH, MPA, and colleagues observed a 91 percent reduction in MRSA central line associated bloodstream infections, a 62 percent reduction in MRSA catheter-associated urinary tract infections and a 92 percent reduction in MRSA ventilator associated pneumonia. These outcomes were observed in a 16-bed medical ICU, 18-bed surgical ICU and 14-bed neuroscience ICU.
Edmond cautioned this is an observational study using data from a single medical center and was observed in the ICU. Other healthcare facilities may have different results.
"This study demonstrates that a broad focus on implementation of evidenced-based practices designed to reduce all healthcare-associated infections is effective at reducing MRSA infections, and will likely have a more beneficial impact on overall patient outcomes," said Neil Fishman, MD, president of SHEA. These study findings are consistent with guidelines for infection prevention and control in healthcare settings.
The Society for Healthcare Epidemiology of America (SHEA), the Centers for Disease Control and Prevention (CDC), the Association for Professionals in Infection Control and Epidemiology (APIC), Inc. and the Infectious Diseases Society of America (IDSA) are convening the Fifth Decennial International Conference on Healthcare-Associated Infections 2010, the scientific event to set the agenda for preventing healthcare-associated infections for the next decade March 18-22, 2010 in Atlanta.