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Control of epidemic methicillin-resistant Staphylococcus aureus
K A Murray-Leisure1, S Geib, D Graceley
1Department of Medicine, Lebanon Veterans' Administration Medical Center, PA 17042.
Abstract:
We controlled the spread of epidemic methicillin-resistant Staphylococcus aureus (MRSA) infection in an 884-bed veterans' facility by cohorting known active MRSA carriers and MRSA-infected patients on one nursing unit. Simultaneously, all previously-institutionalized transfers into the veterans' facility were screened with swab cultures for MRSA at the time of admission. All MRSA patients were maintained on contact (gown and glove) or strict isolation and treated aggressively with topical and enteral antibiotics with the assistance of the infectious disease consultant. The monthly incidence of new MRSA patients dropped from a maximum of 16 per month to three or less per month within six months of instituting these infection control measures. There were no further MRSA bacteremias after the establishment of the MRSA cohort in a single unit. Aggressive cohort management of known MRSA patients and screening of previously-institutionalized patients on admission for MRSA controlled epidemic MRSA in this large institution.
Insights
Implementing a strategy of cohorting patients with methicillin-resistant Staphylococcus aureus (MRSA) and screening new admissions significantly reduced MRSA infections. This infection control approach proved effective in a large healthcare setting.
Area of Science:
- Infectious Disease Epidemiology
- Healthcare-Associated Infections
- Antimicrobial Resistance
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings, leading to difficult-to-treat infections.
- Controlling epidemic MRSA spread requires robust infection control strategies within large veteran facilities.
Observation:
- MRSA infection control was implemented by cohorting known carriers and infected patients onto a single nursing unit.
- Simultaneous screening of all previously-institutionalized admissions for MRSA via swab cultures was initiated.
- MRSA patients were managed with contact or strict isolation and aggressive topical/enteral antibiotic treatment.
Findings:
- The monthly incidence of new MRSA cases decreased from a maximum of 16 to three or fewer within six months.
- No further cases of MRSA bacteremia were observed after the implementation of the MRSA cohort unit.
- Aggressive cohort management and admission screening effectively controlled epidemic MRSA.
Implications:
- This study demonstrates a successful, scalable model for controlling MRSA outbreaks in large healthcare institutions.
- The findings support the integration of targeted patient cohorting and admission screening as key infection control measures.
- Effective MRSA management can reduce patient morbidity and healthcare-associated costs.