Better MRSA Strategy: Treat All ICU Patients
Treating all patients in a hospital ICU as if they were infected with methicillin resistant staphylococcus aureus reduces positive bacterial cultures and bloodstream infections by 44%, research shows.
The relatively rare practice of universally treating all intensive care unit patients as if they were infected, and not screening them for pathogens first, reduces positive bacterial cultures and bloodstream infections dramatically more than screening patients and isolating those who test positive, according to a surprising study published Thursday.
"We now have a very large trial with strong evidence that universal decolonization is better, and it would behoove many hospitals to consider moving to that strategy," says Susan Huang, MD, principal investigator and medical director of epidemiology and infection prevention at the University of California Irvine Health. The study was published in the New England Journal of Medicine.
"What we found, a 44% reduction, represents a remarkable difference" when compared with two other strategies tested, she says. "This has been a really long-standing debate in medicine: Whether we should target high-risk germs or target high-risk people, and this trial answers that question. It's much better to target high-risk patients.
"A strategy that looks to screen and find people who have MRSA, and then do something for them then, is inferior to treating everybody in an ICU as if they are critically ill."