Treat everyone for MRSA

Treating every single patient who enters an intensive care unit with special disinfectant soaps and ointments drastically reduces the spread of the drug-resistant bacteria MRSA and cuts the rate of bloodstream infections in hospitals, a new study shows.

To determine how hospitals step up against HAI and MRSA, researchers from University of California Irvine School of Medicine conducted a study on about 75,000 patients in 43 hospitals around the country.
Patients in the ICU were clustered in three different groups, following three strategies:

  • Group 1: implemented MRSA screening and isolation, the routine treatment for MRSA diagnosis.
  • Group 2: targeted decolonization. For five days, they were treated with an antibiotic nasal ointment and bathed with an antiseptic soap known as chlorhexidine.
  • Group 3: universal decolonization. All patients in the intensive care unit received the nasal ointment and the antiseptic wash for the duration of their stay.

“This last strategy says forget the screening and save your money, they are all at high risk,” Dr. Susan S. Huang, the lead author of the study and an associate professor at the University of California, Irvine School of Medicine. “It is certainly the easiest strategy to implement. You treat all of the patients and protect them from all pathogens.”

The study found that, compared with treating only those patients harboring MRSA, the universal strategy of disinfecting everyone in the I.C.U. reduced the number of all bloodstream infections by 44 percent. It also reduced positive tests for MRSA by 37 percent.

Dr. Huang said that one of the benefits of the study was that it highlighted an approach that can be implemented in essentially any hospital in the country.