MRSA Bloodstream Infections Cut by 44 Percent, Study Concludes

Cleansing the skin of all intensive care patients daily with antiseptic wipes and applying antimicrobial ointment to their noses significantly decreases their risk of having a clinical methicillin-resistant Staphylococcus aureus (MRSA) isolate and also decreases their risk of bloodstream infections due to all pathogens, according to a study of 75,000 patients. The study results were presented for the first time at IDWeek 2012 in San Diego and may suggest a major change in health care practice that could help save lives.

“The strategy that proved to be most effective was perhaps the most straightforward: All patients were bathed daily with chlorhexidine antiseptic soap for the duration of their ICU stay and all received mupirocin antibiotic ointment applied in the nose for five days,” said Mary Hayden, MD, associate professor of infectious diseases and pathology at Rush University Medical Center, and one of the co-authors of the study. “This approach proved to be more effective than screening intensive care unit patients for the bacteria and then focusing on those identified as carriers.”

Investigators found that the number of patients harboring MRSA, those at risk for later illness and for spreading it to others, dropped by more than a third. Bloodstream infections caused by MRSA and other pathogens decreased by almost half.

The study involved nearly 75,000 patients in 43 mostly community hospitals in 16 states and involved each hospital’s own quality improvement team, which indicate that the study’s findings may have widespread applicability to hospitals across the country.

“In ICUs, these infections are generally caused by increasingly antibiotic-resistant bacteria that for most people live harmlessly on the skin or, particularly in the case of MRSA, in the nose,” said Robert Weinstein, MD, a co-author of the study. He is professor of medicine at Rush and chair of the Department of Medicine of John H. Stroger, Jr. Hospital of Cook County.

“These are often preventable infections that can cause serious complications for patients. These results are critical when assessing whether other measures, either targeted or universal, would have greater impact,” Weinstein said.

The study was among the significant work discussed at the inaugural IDWeek meeting in San Diego. IDWeek featured the latest science and bench-to-bedside approaches in prevention, diagnosis, treatment, and epidemiology of infectious diseases, including HIV, across the lifespan. More than 1,500 abstracts from scientists in this country and internationally were highlighted over the conference’s five days.

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