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.
Â
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).
Â
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
Â
COVID-19 Harmonization: Balancing Risks and Benefits of CDC's Latest Move
March 11th 2024The CDC's recent decision to align recommendations for respiratory viruses, particularly COVID-19, has garnered support from the public and infectious disease societies. However, as the Infectious Diseases Society of America (IDSA) lends its backing to the CDC's harmonization efforts, concerns persist regarding the implications of this shift, especially considering the Omicron variant's unique characteristics and the ongoing challenges posed by COVID-19's multi-system impacts.
Voices of Resilience: Q&A With the Editor of "Corona City: Voices From an Epicenter"
March 1st 2024Step into the diverse and poignant world of "Corona City: Voices From an Epicenter" with editor Lorraine Ash, MA. In this insightful Q&A, learn about the origins of this remarkable anthology, the challenges faced in capturing raw, unfiltered narratives of the COVID-19 pandemic, and the lasting impact of these stories on readers and communities alike.
Rare Disease Day 2024: Spotlight on Rare Infectious Diseases
February 29th 2024Rare Disease Day on February 29, 2024, shines a global light on the impact of rare diseases, including rare infectious diseases. With a focus on early diagnosis and treatment access, this day highlights the struggles of those with rare conditions.
COVID-19 Realities: Beyond a Respiratory Virus, Addressing Optimism in Pandemic Management
February 28th 2024A recent commentary by Dr. Amesh Adalja in MedPage Today challenges the perception of COVID-19 as solely a respiratory virus, highlighting its broader impact on the body. This analysis questions the notion that COVID-19 should be managed like common respiratory infections, urging a closer look at vaccine effectiveness, the rise of long COVID, and the need for enhanced measures to curb the virus's spread. Let's explore the complexities of COVID-19 management and the pressing realities faced by the US and the world.