Better MRSA Strategy: Treat All ICU Patients

Cheryl Clark, for HealthLeaders Media , May 30, 2013

Huang adds that the study is unusual because among the three strategies tested, "results weren't even close. A 44% reduction is pretty remarkable compared with what we had already been able to achieve in the last five or 10 years."

John Jernigan, MD, an author of the paper who is director of the Centers for Disease Control and Prevention's Office of HAI Prevention Research and Evaluation, called the study's results "dramatic," and the most significant finding on ways hospitals can reduce infections, especially MRSA, methicillin resistant staphylococcus aureus, to come out this year.  A CDC committee is working on issuing guidelines.

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The study also was unusual because it was federally funded by the U.S. Department of Health and Human Services in 43 non-academic community hospitals owned by Hospital Corporation of America, not the traditional cohort of academic medical centers. It included 74,256 patients treated at 74 adult intensive care units between 2009 and 2011.

As a result of the trial, HCA officials said they are making universal decolonization in the ICU, without screening, standard practice in all of their 160 hospitals.

Hospitals were randomly assigned to one of three strategies.

In Group 3, which had the winning strategy, patients in the ICU received twice-daily doses of an antibiotic ointment, mupirocin, in the nose as well as daily baths with chlorhexidine-impregnated cloths during their ICU stay. The strategy did not involve screening patients for MRSA on admission to the ICU.

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