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Updated: Mar 16, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Reduction of methicillin-resistant Staphylococcus aureus infection in long-term care is possible while maintaining
Lance R Peterson1, Susan Boehm2, Jennifer L Beaumont3
1Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, IL; Department of Pathology, University of Chicago Pritzker School of Medicine, Chicago, IL; Division of Infectious Diseases, Department of Medicine, NorthShore University HealthSystem, Evanston, IL; Division of Microbiology, Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, IL; Department of Infection Control, NorthShore University HealthSystem, Evanston, IL.
Background:
Antibiotic resistance is a challenge in long-term care facilities (LTCFs). The objective of this study was to demonstrate that a novel, minimally invasive program not interfering with activities of daily living or socialization could lower methicillin-resistant Staphylococcus aureus (MRSA) disease.
Methods:
This was a prospective, cluster-randomized, nonblinded trial initiated at 3 LTCFs. During year 1, units were stratified by type of care and randomized to intervention or control. In year 2, all units were converted to intervention consisting of universal decolonization using intranasal mupirocin and a chlorhexidine bath performed twice (2 decolonization-bathing cycles 1 month apart) at the start of the intervention period. Subsequently, after initial decolonization, all admissions were screened on site using real-time polymerase chain reaction, and those MRSA positive were decolonized, but not isolated. Units received annual instruction on hand hygiene. Enhanced bleach wipe cleaning of flat surfaces was done every 4 months.
Results:
There were 16,773 tests performed. The MRSA infection rate decreased 65% between baseline (44 infections during 365,809 patient days) and year 2 (12 infections during 287,847 patient days; P <.001); a significant reduction was observed at each of the LTCFs (P <.03).
Conclusions:
On-site MRSA surveillance with targeted decolonization resulted in a significant decrease in clinical MRSA infection among LTCF residents.
Insights
A new program significantly reduced methicillin-resistant Staphylococcus aureus (MRSA) infections in long-term care facilities (LTCFs). On-site surveillance and targeted decolonization lowered MRSA disease by 65% without disrupting daily life.
Area of Science:
- Infectious Diseases
- Public Health
- Geriatric Medicine
Background:
- Antibiotic resistance, particularly methicillin-resistant Staphylococcus aureus (MRSA), poses a significant challenge in long-term care facilities (LTCFs).
- Existing control measures can be invasive and disruptive to residents' quality of life.
Purpose of the Study:
- To evaluate a novel, minimally invasive program to reduce MRSA infections in LTCFs.
- To assess the program's impact on daily activities and resident socialization.
Main Methods:
- A prospective, cluster-randomized trial was conducted across 3 LTCFs.
- The intervention involved universal decolonization (intranasal mupirocin and chlorhexidine baths), on-site MRSA screening of admissions with real-time PCR, targeted decolonization, and enhanced hand hygiene and environmental cleaning.
- Decolonization was performed twice initially, with subsequent decolonization for positive MRSA screens, without isolation.
Main Results:
- The MRSA infection rate decreased by 65% from baseline to year 2 (44 infections vs. 12 infections).
- This reduction was statistically significant across all participating LTCFs (P < .001).
Conclusions:
- On-site MRSA surveillance combined with targeted decolonization effectively reduced clinical MRSA infections in LTCF residents.
- The implemented program was minimally invasive and did not interfere with resident activities or socialization.
