Methicillin-resistant Staphylococcus aureus infection rate after implementation of an antibiotic care bundle based on...

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Microbiology

Background:

• Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is a known risk factor for invasive MRSA infections, especially in critical care settings.
• Intensive Care Units (ICUs) are high-risk environments for MRSA transmission and subsequent infections.

Purpose of the Study:

• To evaluate the effectiveness of implementing a specific MRSA antibiotic care bundle (ACB) combined with rapid molecular screening and de-colonization.
• To determine if this intervention reduced the overall MRSA infection rate among ICU patients.

Main Methods:

• A surveillance study was conducted in an ICU, comparing pre-ACB (April 2009-December 2010) and post-ACB (January 2011-December 2012) periods.
• Nasal swabs from 431 (pre-ACB) and 577 (post-ACB) ICU patients were analyzed using the rapid molecular test Xpert MRSA.
• Patients were monitored throughout their ICU stay for MRSA infection development.

Main Results:

• MRSA colonization rates at admission were 7.1% (pre-ACB) and 8.4% (post-ACB).
• The rate of MRSA infection in the ICU significantly decreased from 2% to 0.3% post-ACB implementation.
• A 100% decrease in MRSA infections was observed over two consecutive semesters between July 2011 and July 2012 (p<0.001).

Conclusions:

• The introduction of rapid molecular surveillance and a targeted MRSA antibiotic care bundle led to a significant reduction in MRSA infections within the ICU.
• The intervention also decreased the risk associated with MRSA bacteremia.