April 15, 2011

MRSA Still Spreading in ICUs

(Ivanhoe Newswire) --The current tactics hospitals are using to fight the spread of resistant bacteria in ICUs may not be working. A new multisite study led by the Mayo Clinic found that a commonly used strategy has not effectively helped to prevent the spread of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE).

Thousands of Americans die from MRSA infections each year. Both MRSA and VRE are resistant to antibiotics and are difficult to treat if patients become infected. One strategy used to prevent the spread of the bacteria is called "active surveillance." It includes screening patients admitted to ICUs to see if they carry the bacteria and then implementing barrier precautions that require health care providers to wear gloves and gowns when handling these patients.

For the study, researchers examined and collected data from 18 ICUs at academic medical centers around the U.S. Each ICU was randomly assigned to provide care using the intervention strategies (active surveillance and barrier precaution) or its existing (control) procedures.

The findings showed there was no difference in the frequency of new infection events with MRSA or VRE when comparing intervention ICUs to control ICUs. The researchers reasoned that simply identifying patients through active surveillance and the use of barrier precautions is not enough to make a difference. They suggest that doing a better job of following isolation precautions is important but may need to be complemented by reducing the presence of bacteria on body sites and improving environmental cleaning.

"We were surprised by the 'no effect' result, especially given two facts. First, many patients who were not previously known to be carriers of MRSA or VRE were identified by active surveillance. Secondly, MRSA or VRE positive patients were cared for using barrier precautions for nearly their entire ICU stay," W. Charles Huskins, M.D., Mayo Clinic infectious diseases specialist and lead author of the article, was quoted as saying.

Source: New England Journal of Medicine, April 13, 2011