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Improving hand hygiene best option to reduce CA-MRSA in hospitals
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Optimal hand hygiene was associated with the greatest benefit in reducing the spread of community-associated methicillin-resistant Staphylococcus aureus in hospitals, according to results of a mathematical model study that examined efforts to combat MRSA in health care facilities.
The study results also indicated that screening for CA-MRSA and decolonization methods were effective in reducing the spread of the infection. However, the most significant reduction was associated with improved compliance with hand hygiene. The researchers said improved compliance with hand hygiene had the “greatest return of benefits” and that if compliance was implemented correctly, other strategies may have only “minimal added benefit.”
In recent years, experts have warned that hospitals may need to improve infection control standards, especially as CA-MRSA USA300 has become more prevalent. This study was designed as a deterministic mathematical model to better understand the effectiveness of interventions aimed to reduce the spread of CA-MRSA in health care facilities.
The mathematical model also examined the potential for further spread of CA-MRSA in health care facilities. These results suggested that CA-MRSA is expected to soon become the “dominant MRSA strain in hospitals and health care facilities.” The researchers also warned that CA-MRSA infections are likely to become more severe and result in longer hospitalizations, which will also foster “a larger in-hospital reservoir of CA-MRSA.”
Clin Infect Dis. 2009;48:274-284.
Compliance with hand hygiene is the best way to prevent the spread of CA-MRSA, as well as health care–associated MRSA. Unfortunately, optimizing hand hygiene practices is the “holy grail” of health care. Despite intensive and diverse efforts, optimizing hand hygiene practices and maintaining high levels of compliance have been extremely difficult to achieve.
Screening may become more beneficial once more tests are available. CA-MRSA often is not detectable in the nares, but rapid tests for identifying MRSA colonization are approved only for nares specimens. Also, colonization with CA-MRSA more commonly occurs in the throat, but current rapid tests are not approved for use on these types of specimens.
— Keith Kaye, MD
Infectious Disease News Editorial Board member