Intervention significantly reduces MRSA in Veterans living center
Recent findings presented at the Association for Professionals in Infection Control and Epidemiology annual conference showed that an intervention led by the Veterans Health Administration reduced the number of MRSA infections in a Veterans community living center by more than 89% over a 4-year period.
Researchers estimated that the intervention prevented 64 MRSA infections over the study duration, saving approximately $2.2 million in costs, according to a press release.
“The cornerstone of this program was strict environmental control, decontamination and cleaning,” Lanette Hughes, RN, BSN, infection preventionist at the Salisbury VA Community Living Center, said in the release. “In addition to the substantial monetary savings from using less personal protective equipment, this initiative also fostered a better environment for residents and staff, improving the overall workflow of the living centers.”
The intervention was launched at the Veterans community living centers (CLC) in Salisbury, NC, in 2012 after a previous Veterans Health Administration (VHA) initiative involving an uptake in hand hygiene and contact precautions in all CLCs failed to reduce the prevalence of MRSA. Instead, researchers observed an increase in MRSA from 23% in 2007 to more than 60% in 2012.
For the new intervention at the Salisbury CLC, which was approved by the CLC’s town council, staff members performed an initial MRSA decolonization process involving chlorhexidine bathing and intranasal application of mupirocin for 5 consecutive days among all colonized residents. In addition, each resident’s room was cleaned daily and disinfected with ultraviolet C light. After initial decolonization, staff implemented a “search and destroy” program, which called for quarterly screening among all CLC residents and immediate decolonization among any new Veterans admitted to the CLC with MRSA colonization, according to the release.
From November 2012 to December 2016, the prevalence of health care-associated MRSA infections decreased from 0.47 per 1,000 bed days of care (BDOC) to 0.05 infections per 1,000 BDOC, representing an 89.4% reduction during the intervention period. There was also a 72% reduction in the prevalence of MRSA colonization, which researchers said was sustained during 48 months of follow-up.
The intervention further reduced the prevalence of other health care-associated infections caused by multidrug-resistant organisms. The researchers reported a 62.5% reduction in extended-spectrum beta-lactamase (ESBL)–producing Escherichia coli and a 100% reduction in ESBL–producing Klebsiella spp., vancomycin-resistant Enterococcus, carbapenem-resistant Enterobacteriaceae and Clostridium difficile.
“This research shows the positive impact that targeted infection prevention interventions can have on patient safety and health care costs,” 2017 APIC President Linda Greene, RN, MPS, CIC, FAPIC, said in the release. “It is important that infection preventionists have the latitude and resources to design programs to address the infection risk at their facilities.” – by Stephanie Viguers
Hughes L, et al. A 4-year look at the effect of methicillin-resistant Staphylococcus aureus (MRSA) decolonization on health care-associated infections in a community living center. Presented at: Annual Conference of the Association for Professionals in Infection Control and Epidemiology; June 14-16, 2017; Portland, Oregon.
Disclosure: The researchers report no relevant financial disclosures.