Logo Image
|Articles|November 15, 2012

Screening HCWs, Decolonization of MRSA Carriers Unlikely to Reduce Nosocomial Spread of MRSA

Control of methicillin-resistant Staphylococcus aureus (MRSA) transmission has been unsuccessful in many hospitals. Recommended control measures include isolation of colonized patients, rather than decolonization of carriage among patients and/or healthcare workers, yet the potential effects of such measures are poorly understood.
 
Gurieva, et al. (2012) describe a stochastic simulation model in which healthcare workers can transmit MRSA through short-lived hand contamination, or through persistent colonization. Hand hygiene interrupts the first mode, decolonization strategies the latter. The researchers quantified the effectiveness of decolonization of patients and healthcare workers, relative to patient isolation in settings where MRSA carriage is endemic (rather than sporadic outbreaks in non-endemic settings caused by healthcare workers).
 
Patient decolonization is the most effective intervention and outperforms patient isolation, even with low decolonization efficacy and when decolonization is not achieved immediately. The potential role of persistently colonized healthcare workers in MRSA transmission depends on the proportion of persistently colonized healthcare workers and the likelihood per colonized healthcare worker to transmit. As a stand-alone intervention, universal screening and decolonization of persistently colonized healthcare workers is generally the least effective intervention, especially in high endemicity settings. When added to patient isolation, such a strategy would have maximum benefits if few healthcare workers cause a large proportion of the acquisitions.

The researchers conclude that in high-endemicity settings regular screening of healthcare workers followed by decolonization of MRSA-carriers is unlikely to reduce nosocomial spread of MRSA unless there are few persistently colonized healthcare workers who are responsible for a large fraction of the MRSA acquisitions by patients. In contrast, decolonization of patients can be very effective. Their research is published in BMC Infectious Diseases.

Reference: Gurieva TV, Bootsma MCJ and Bonten MJM. Decolonization of patients and healthcare workers to control nosocomial spread of methicillin-resistant Staphylococcus aureus: a simulation study. BMC Infectious Diseases 2012, 12:302 doi:10.1186/1471-2334-12-302
 

Related to this article

View more
Infection preventionists in full PPE with children in DRC. (Image credit: author with AI)
Chasing the Bundibugyo Outbreak: How Static Numbers Hide a Moving Epidemic
Nearly 4 months into the DRC's Bundibugyo virus disease outbreak, some indicators suggest transmission may be slowing. But shifting hotspots, treatment-center capacity problems, community deaths, and incomplete surveillance data show why national case totals alone cannot determine whether containment has been achieved.
Read more
Health care workers from the US speaking with other health care workers in DRC. (Image credit: author with AI)
What Outbreak Metrics Can and Cannot Tell Us About the Ebola DRC Response
Is the Ebola outbreak in the DRC getting better? The answer depends on which numbers you examine. Several important indicators are moving in the right direction, including slower case growth and a declining Rₜ. But major gaps remain in contact tracing, testing, community deaths, safe burial coverage, and treatment capacity in some of the hardest-hit areas. ICT takes a deeper look at the latest outbreak data and why the numbers suggest cautious optimism, not victory.
Read more
Dyan Troxell, MSN, RN, director of clinical education at HandCraft Linen Services; J.J. Odom, MBA, CHESP, CMIP, T-CHEST, university director of buildings and grounds for UConn Health and chair-elect of the AHE Board; and Jenna Rivers, MPH, CPH, CIC, manager of infection prevention and control at Moffitt Cancer Center in Tampa, Florida.
At AHE Exchange26: Building Safer, Smarter Reusable Linen Programs
At AHE Exchange 2026, ICT spoke with experts representing commercial laundry services, EVS, and infection prevention about the systems behind a successful reusable linen program. They discuss linen quality, reject rates, unnecessary waste, frontline education, data, PAR levels, infection prevention oversight, and why strong relationships between health care facilities and their laundry providers matter.
Read more
A group of students raising their hands in class during a lecture (Adobe Stock 292282454 by Mediteraneo
Once a Teacher, Always a Teacher: Why Infection Prevention Is Education
How do you celebrate an infection that never happened? That's one of the unusual challenges infection preventionists share with teachers. Both can spend their careers changing outcomes they may never see. Both educate people who don't always want to listen. Both are second-guessed. Both face burnout. And both must somehow keep remembering why they started.
Read more