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Universal decolonization cut ICU bloodstream infections nearly in half
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SAN DIEGO — Using antimicrobial soap and ointment on all patients in adult intensive care units significantly reduced the number of bloodstream infections, according to study results presented at ID Week 2012.
“We believe this finding will influence guidelines to ensure the health and safety of patients in highly vulnerable settings,” Susan Huang, MD, associate professor at the University of California, Irvine School of Medicine, and medical director of epidemiology and infection prevention at University of California, Irvine Healthcare, said during a media briefing. “This study suggests that treating all ICU patients with this strategy is beneficial. If adopted, it may make screening for drug-resistant organisms unnecessary.”
Susan Huang
Huang and colleagues conducted a three-arm cluster-randomized trial of three different strategies to prevent methicillin-resistant Staphylococcus aureus infections. The three strategies included: screening and isolation of patients positive for MRSA; targeted decolonization of patients positive for MRSA, using chlorhexidine baths and mupirocin for 5 days; and universal decolonization of all patients using mupirocin for 5 days and daily chlorhexidine baths for duration of ICU stay.
The study took place in 43 community hospitals and included nearly 75,000 patients. They found that universal decolonization of all patients resulted in a 44% reduction in infections resulting from all pathogens, not just MRSA. For only MRSA, there was a 37% reduction in the risk for an MRSA clinical isolates.
“This study answers a hotly debated question in the medical field: whether to target patients who have high-risk pathogens or to target all patients in a high-risk setting,” Huang said. “We’re pleased to find that the universal approach is better.”
Because the trial was conducted primarily in community hospitals as opposed to academic medical centers, the results should translate broadly to all US hospitals, Huang said, adding that the results are limited to the ICU setting, and it is important to be vigilant about whether this strategy will increase antibiotic resistance.
For more information:
Huang S. #36049. Presented at: ID Week 2012; Oct. 16-19, 2012; San Diego.
Disclosure: Huang reports no relevant financial disclosures.