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Nasal MRSA testing upon hospital admission reduces clinical infection

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BOSTON — Active surveillance testing for nasal MRSA carriages appeared to reduce the incidence of clinical infection, according to a longitudinal analysis presented at ASM Microbe 2016.

In August 2005, the NorthShore University HealthSystem expanded its MRSA surveillance system to include all admitted patients, and in January 2012 reduced testing to those who were at high risk for MRSA. To examine the impact of these screening policies, Donna M. Schora, MT, microbiologist at NorthShore University HealthSystem, and colleagues reviewed MRSA infection rates within the system from Aug. 1, 2003, to July 31, 2015. Staff from the three participating hospitals collected and tested nasal samples within 24 hours of admission, with those testing positive placed in contact isolation, administered nasal mupirocin and bathed with chlorhexidine. Staff monitored screening to ensure more than 90% compliance, and a fourth hospital was added to the health network in 2010.

Compared with a baseline incidence of 8.9 cases per 10,000 patient-days, clinical MRSA infections declined to 3.9 cases per 10,000 patient days (P <.001) within 18 months of extending surveillance to all admissions. Rates of nosocomial MRSA infections among each hospital — including the one acquired in 2010 — declined approximately 70% by the end of the study period (P < .001).

The risk-based screening algorithm implemented in 2012 limited testing to approximately half of all admissions, Schora said, yet has captured more than 90% of potential carriers and continues to be practiced at all four hospitals.

“The MRSA nosocomial infection rate decreased over time, and continues to remain below pre-surveillance levels,” Schora said. “Our final MRSA nasal program is an effective way to reduce MRSA clinical infection, and will continue to be a part of our infection control program.” – by Dave Muoio

Reference:

Schora DM, et al. The impact of MRSA admission nasal surveillance on nosocomial infection: Ten years of testing. Presented at: ASM Microbe; June 16-20, 2016; Boston.

Disclosure: Schora reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.