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Multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak and its control after use of the Veterans
Risa M Webb1, Carmelita Denton2, Emily Spruill2
1G.V. "Sonny" Montgomery Veterans Affairs (VA) Medical Center, Jackson MS; Univeristy of Mississippi Medical Center, Jackson, MS.
Abstract:
A multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak with 91 infections occurred in our Veterans Affairs (VA) community living center over 46 months. Both similar and unique strains were shown by repetitive polymerase chain reaction to contribute to the outbreak, including 1 strain causing infections over a 33-month period. Most infections were soft tissue infections (67%). For 21 months after the initiation of the VA MRSA bundle, no infections were identified, and low rates of infection have been sustained an additional 4 years. The average annual rate of MRSA infection decreased by 62% (P < .001) from 0.6 per 1,000 resident days for 4 years prior to the bundle implementation to 0.09 per 1,000 resident days for 4 years after the bundle implementation.
Insights
A multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak was controlled by implementing the VA MRSA bundle. This intervention significantly reduced infection rates, demonstrating the bundle
Area of Science:
- Infectious Diseases
- Public Health
- Veterans Health Administration
Background:
- A significant multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak occurred in a VA community living center, resulting in 91 infections over 46 months.
- Repetitive polymerase chain reaction (PCR) analysis identified both similar and unique MRSA strains contributing to the outbreak, with one strain persisting for 33 months.
- The majority of infections (67%) were soft tissue infections.
Purpose of the Study:
- To evaluate the effectiveness of the VA MRSA bundle in controlling a multiclonal MRSA outbreak.
- To assess the impact of the MRSA bundle on infection rates within a community living center setting.
Main Methods:
- Implementation of the VA MRSA bundle intervention.
- Surveillance of MRSA infections before and after bundle implementation.
- Analysis of infection rates using resident days as a denominator.
Main Results:
- Following the initiation of the VA MRSA bundle, no MRSA infections were identified for 21 months.
- Sustained low infection rates were observed for an additional 4 years post-bundle implementation.
- The average annual MRSA infection rate decreased by 62% (P < .001) after the bundle's implementation, from 0.6 to 0.09 per 1,000 resident days.
Conclusions:
- The VA MRSA bundle was highly effective in controlling a prolonged multiclonal MRSA outbreak.
- The intervention led to a significant and sustained reduction in MRSA infection rates in a VA community living center.
- The findings support the widespread adoption of the VA MRSA bundle to prevent and manage MRSA infections in similar healthcare settings.
