Interfering with ICU Infections

MRSA and bloodstream infections reduced in ICUs with antibacterial precautions

(RxWiki News) Entering the hospital for one reason but having to prolong your stay due to infection is not an uncommon event. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the more notorious causes for these infections.

MRSA is resistant to multiple drugs and can sometimes cause life-threatening infections. However, a new study found that requiring all patients in intensive care units (ICUs) to use antibacterial products considerably reduced bloodstream infections and presence of MRSA.

"Wash your hands with soap and water."

According to the Centers for Disease Control and Prevention (CDC), the majority of MRSA infections are skin infections and, while painful, are usually not life-threatening. The more severe MRSA infections are more likely to occur in patients in healthcare settings.

To examine MRSA in hospitals, a team led by Susan S. Huang, MD, MPH, of the Division of Infectious Diseases and Health Policy Research Institute at the University of California Irvine School of Medicine, looked at 43 hospitals (with 74 ICU units) in 16 different states.

The researchers divided ICUs into three groups. In the first group, contact precautions against MRSA were used on patients who tested positive for MRSA presence or had a history of MRSA. According to the study authors, this is the standard method in hospitals and involves using gloves and separating patients.

In the second group, those who had MRSA or a history of MRSA used germ-killing soap and a nasal ointment for five days (targeted decolonization). In the third group, all patients used the nasal ointment for five days and the soap for their entire ICU stay (universal decolonization).

More than 74,000 patients were involved over an 18 month period in which the researchers studied the three methods. Prior to this period, there was a year-long observation of the hospitals to establish a baseline.

After analyzing the data, the authors determined that universal decolonization, or administering germ-killing products to all ICU patients, was the most effective method. This group saw a 37 percent reduction in presence of MRSA and a 44 percent reduction of bloodstream infections from any infectious agent. 

By contrast, giving the antibacterial soap and ointment only to patients identified with MRSA reduced bloodstream infections by only 23 percent.

The authors did note the possibility that widespread use of antibacterial products could create resistance to these germ-killing substances. Because of this concern, they wrote that programs to watch for potential changes in resistance are needed.

In response to the study, the CDC’s director Tom Frieden, MD, MPH, said that the “CDC is working to determine how the findings should inform CDC infection prevention recommendations.”

The study was published in the New England Journal of Medicine on May 29.

The research team included researchers from the University of California, Irvine, Harvard Pilgrim Health Care Institute, Hospital Corporation of America and the CDC.

Several of the authors reported ties, including lecture fees, research and unpaid consultant work, to Sage Products, a company that produces hygiene products.

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Review Date: 
May 31, 2013