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MRSA Management Takes Leadership

 |  By Cora Nucci  
   January 19, 2011

A study out of Boston finds that one reason MRSA is so stubbornly present in hospitals is because a significant percentage of patients present in the emergency department with the drug-resistant staph infection already onboard.

Five percent may not sound like a significant number, but more than half carried MRSA on multiple sites, according to a study published in the Annals of Emergency Medicine, increasing the likelihood of transmission.

Widely regarded as a deadly superbug responsible for close to 500,000 hospitalizations and 19,000 deaths a year in the United States, MRSA is reportedly in decline. But if it's in your hospital (or on your leg), those are the only data points that count.

The good news is that best practices for infection control don't hinge exclusively on costly or complicated measures that may be out of reach to healthcare facilities without deep pockets.

On the contrary, the first line of defense is handwashing, a simple and inexpensive maneuver too often taken lightly by busy hospital staff. Hand hygiene is remarkably effective at reducing rates of infection transmission, but must be reinforced by hospital leaders. Monetary incentives, marketing campaigns, and the pressure of accountability (sometimes via the use of spies) are all effective tools for nudging handwashing compliance upward.

Also effective is the use of gowns and gloves and isolation of MRSA-positive patients. Hospitals with multi-bed ICUs have been found to have significantly higher incidences of infection, than those with single-bed ICUs, say researchers at McGill University. Hospitals that convert multi-bed units to single-bed private rooms with their own sinks—slashed hospital-acquired infection ratesincluding MRSA—by half.

The news about MRSA is improving, albeit slowly. University of Rochester Medical Center orthopedic scientists announced this week that they are a step closer to reducing the risk of the deadly bug.

The team discovered an antibody that can stop MRSA bacteria from growing in mice and in cell cultures. It's a long way off from zapping the bacteria on a person's skin, but it's a step in the right direction.

"A vaccine in humans would probably not be a foolproof approach to preventing infection 100%of the time," team leader Edward M. Schwarz, PhD, said in a statement. "However, even if we could reduce the risk of MRSA by 35%, that would be an enormous improvement in the field."

So until a MRSA vaccine is at hand, basic methods of transmission prevention are key. They can and should be reinforced in ambulatory centers, community health clinics, acute care facilities, doctors' offices, and teaching hospitals alike. MRSA is indiscriminate, so healthcare providers must redouble their efforts to stop it cold.

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