Infection Control

Study finds a decline in MRSA in the ICU

Briefings on Infection Control, May 1, 2009

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On an all-too-regular basis, newspaper headlines depict grim trends related to MRSA, both in the hospital and the community. Health officials have been left scrambling to mitigate the pathogen’s drug resistance, and IPs are working hard to prevent it from entering their hospitals. But a recent study published in the February 18  Journal of the American Medical Association (JAMA) offers a glimmer of hope in the fight against this antibiotic-resistant infection.

Researchers at the CDC examined trends regarding the incidence of MRSA in central line–associated bloodstream infections (CLABSI) in U.S. ICUs. Data reported to the CDC through the National Nosocomial Infections Surveillance system from 1997 to 2004 were used in conjunction with data from the National Healthcare Safety Network (NHSN) that were phased in by the CDC in 2005.

After analyzing data over the 10-year period, researchers found that although MRSA CLABSI incidence from 1997 to 2001 increased in some ICU settings, from 2001 to 2007, MRSA rates declined in all ICU types except pediatric units. Overall, the CLABSI incidence decreased 49.6% over the 10-year span.

Why ICUs?

The study focused on a particular set of parameters. It concentrated on data related to MRSA bloodstream infections, specifically at ICUs.

Deron C. Burton, MD, JD, MPH, lieutenant commander at the U.S. Public Health Service assigned to the CDC, and lead researcher of the study, says the reason for studying ICUs specifically was mostly a result of very limited parameters offered by the data.

“The surveillance systems that we have been using to gather this data have traditionally been focused on the ICU setting,” Burton says. “Even though we have non-ICU settings included in the most current version of the surveillance system, in order to have continuity of reporting over the last 10 years of surveillance data, we actually needed to limit it to the ICUs.”

Shortly after the study was published, APIC CEO Kathy L. Warye released a statement about the report’s results.

“This is encouraging news for patients and the healthcare community,” Warye said in the statement. “While central line–associated bloodstream infections caused by MRSA represent only a small fraction of the overall number of MRSA infections, this analysis demonstrates that healthcare-associated infections [HAI] can be prevented in a very vulnerable group of patients when institutions consistently implement evidence-based prevention strategies.”

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