Working To Prevent and Eliminate MRSA Infections

As the United Nations decreed last week, antibiotic-resistant infections are a global threat.  When bacteria become resistant to antibiotics, routine infections can be life-threatening.

One of the best-known antibiotic-resistant bacteria is MRSA, methicillin-resistant Staphylococcus aureus. Healthy people often carry MRSA on their skin and in their noses without developing an infection. Because people can have MRSA on their bodies without signs of illness, it is easy for the bacteria to escape notice and be transmitted to and between hospital patients and cause dangerous complications.

October is MRSA Awareness Month. That observance, kicked off by World MRSA Day on October 2, seeks to galvanize survivors, communities, governments, and health care officials and personnel to eliminate this preventable disease. The global focus on antibiotic resistance may be recent, but AHRQ’s work in this area is not. 

REDUCE-MRSA, an AHRQ-funded study carried out as a public-private partnership that involved AHRQ, the Centers for Disease Control and Prevention, and the Hospital Corporation of America, has already led to changes in the MRSA prevention practices of intensive care units (ICUs) across the country.  In this cluster-randomized controlled trial, investigators determined that a combination of bathing every patient admitted to the ICU with germ-killing soap and applying an antibiotic ointment in the nose, a strategy known as universal decolonization, worked better than two commonly used screening and prevention methods. ICUs that used universal decolonization reduced the presence of MRSA; they also reduced bloodstream infections caused by all bacteria by over 40 percent.

To help other ICUs apply the effective methods developed through this research, AHRQ posted online the Universal ICU Decolonization: An Enhanced Protocol. The protocol walks users through the process for implementing universal decolonization in ICUs.

What we learned in REDUCE-MRSA—that decolonizing ICU patients works—is now being tested in other settings.  AHRQ-funded investigators are now addressing these questions in related studies:

• Can MRSA infections be prevented if patients who were found to carry MRSA during their hospital stay are discharged with a decolonization protocol?
• Will decolonizing all nursing home residents reduce MRSA infections and prevent hospital readmissions?
• For households in which a child has had a recent MRSA infection, will decolonization of families decrease MRSA infections?

Every healthcare-associated infection (HAI) prevented is one less episode of antibiotic use and one less opportunity for resistance to develop.  Preventing these infections keeps patients safe from harm and reduces the need for antibiotics.  World MRSA Day’s ultimate goal is to eliminate MRSA, a goal that AHRQ shares along with others across the Federal Government as we all work to prevent HAIs.