Cross-Transmission Prevention Pays Dividends in MRSA Reduction

In France, the proportion of MRSA has been more than 25 percent since 2000. Prevention of hospital-acquired (HA) MRSA spread is based on isolation precautions and antibiotic stewardship. At one institution, before 2000, the infection disease and the infection control teams had failed to reduce HA-MRSA rates.

Chalfine, et al. (2012)  implemented a multifaceted hospital-wide prevention program and measured the effects on HA-MRSA colonization and bacteremia rates between 2000 and 2009. From 2000 to 2003, active screening and decontamination of ICU patients, hospital-wide alcohol based hand rubs (ABHR) use, control of specific classes of antibiotics, compliance audits, and feed-backs to the care providers were successively implemented. The efficacy of the program was assessed by HA-MRSA colonized and bacteremic patient rates per 1000 patient-days in patients hospitalized for more than 24 hours.

Compliance with the isolation practices increased between 2000 and 2009. Consumption of ABHR increased from 6.8 L to 27.5 L per 1000 patient-days. The use of antibiotic defined daily doses (DDD) per 1000 patient-days decreased by 31percent. HA-MRSA colonization decreased by 84  percent from 1.09 to 0.17 per 1000 patient-days and HA-MRSA bacteremia by 93 percent, from 0.15 to 0.01 per 1,000 patient-days (p<10-7 for each rate).
 
In an area highly endemic for MRSA, the researchers say a multifaceted prevention program allows for sustainable reduction in HA-MRSA bacteremia rates. Their research was published in Antimicribial Resistance and Infection Control.

Reference: Chalfine A, et al. Ten-year decrease of acquired methicillin-resistant Staphylococcus aureus (MRSA) bacteremia at a single institution: the result of a multifaceted program combining cross-transmission prevention and antimicrobial stewardship. Antimicrobial Resistance and Infection Control 2012, 1:18 doi:10.1186/2047-2994-1-18.