profession

Massive study yields answers on MRSA prevention

NEWS IN BRIEF — Posted June 10, 2013

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Bathing all intensive care unit patients with chlorhexidine soap and applying the antibiotic ointment mupirocin is a much more effective way of preventing methicillin-resistant Staphylococcus aureus infections than the typical practice of screening patients for MRSA and then taking infection-control measures, said a cluster-randomized trial of nearly 75,000 patients at 75 ICUs across the country.

This “universal decolonization” approach lowered the odds of MRSA bloodstream infections by 44% and also cut the risk of positive MRSA clinical cultures by about 30%, said the study, published online May 29 in The New England Journal of Medicine (link).

“This study helps answer a long-standing debate in the medical field about whether we should tailor our efforts to prevent infection to specific pathogens, such as MRSA, or whether we should identify a high-risk patient group and give them all special treatment to prevent infection,” said Susan Huang, MD, MPH, the study’s lead author and medical director of epidemiology and infection prevention at University of California Irvine Health in Orange County. “The universal decolonization strategy was the most effective and the easiest to implement. It eliminates the need for screening ICU patients for MRSA.”

In addition to potentially overturning current practice, however, the study makes recommendations counter to laws in some areas. Nine states mandate MRSA screening of inpatients. In an accompanying editorial, two infectious diseases specialists at the Virginia Commonwealth University School of Medicine said the study should prompt hospitals to stop screening all patients for MRSA and requiring contact precautions for health professionals caring for those who test positive. Physicians and hospitals should be cautious about using mupirocin in a widespread fashion that could exacerbate bacterial resistance to the antibiotic, wrote the editorial’s authors, Michael B. Edmond, MD, MPH, and Richard P. Wenzel, MD (link).

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn