Universal Treatment for MRSA in ICUs Is More Effective in Preventing Infections

A study published online this week in the New England Journal of Medicine finds that treating all patients in intensive care units (ICU) for drug-resistant MRSA is more effective in preventing bloodstream infections than screening all patients and isolating those who test positive, which is the most common practice.

The study included nearly 75,000 patients in 74 ICUs in 43 hospitals. Researchers found that treating all patients (universal deconolonization) reduced all bloodstream infections, including those caused by bacteria other than MRSA, by 44 percent. The group of patients who were first screened and isolated if they tested positive for MRSA showed no significant decrease in infections and the gruop of patients who were screened and treated for MRSA if they tested positive showed only a 22 percent reduction in infections.

The treatment involved washing patients with cloths containing antimicrobial soap chlorhexidine and giving them mucipirocin, a nasal antibiotic ointment.

The 43 hospitals in the study were all part of Hospital Corporation of America, which is now implementing the protocol in all its hospital ICUs.

The study notes that widespread use of chlorhexidine and mupirocin could engender resistance.

An INQRI-funded study led by David Thompson and Jill Marsteller, published in Critical Care Medicine found that combining several tested and proven practicies for preventing central line associated bloodstream infections (CLABSIs) with a program to improve safety, teamwork and communications, dramatically reduced infection rates.