How big of a threat is MRSA to hospital infection control?
That's one question that APIC, the Association for Professionals in Infection Control and Epidemiology, hopes to answer with its survey of healthcare facilities, the first attempted since 2006.
"This is absolutely critical information to know, not just for the facilities themselves, but from an overall health perspective," says APIC CEO Kathy Warye. She says that the organization is asking all healthcare facilities to participate to gather as much information as possible.
The deadline for participation is Aug. 1.
MRSA, or Methicillin-resistant Staphylococcus aureus, causes an estimated 19,000 deaths a year in the United States. One patient's care adds more than $60,000 to healthcare costs.
The new survey, launched with Institutional Review Board approvals, attempts to update knowledge about MRSA in healthcare settings since the 2006 survey, and to provide answers about the following aspects of the potentially infectious bacteria .
1. In 2006, APIC's national survey of about 1,200 acute care hospitals and long-term care facilities showed that 46 out of every 1,000 inpatients were either infected or colonized with MRSA, which was a far higher rate than previous estimates. "We want to know if this number has gone up or down," Warye says.
2. How many of those inpatients acquired their infections in the community and how many acquired it from strains transmitted within the healthcare setting?
3. What are hospitals doing to prevent MRSA infections? Are they concentrating efforts in high-risk areas such as intensive care units, or branching out throughout the hospital? In which types of hospitals might more aggressive measures be useful? Warye says that in the recession, many hospitals have cut back their infection control efforts, and it's important to determine what may have been sacrificed.
4. How are hospitals screening patients for infection with community- acquired strains of MRSA when they come in to the facilities? Are just patients who are headed for surgery being tested or other patients as well?
5. How have efforts to control MRSA affected the infection or colonization rates of MRSA bacteria?
The Centers for Medicare & Medicaid Services has not yet begun to penalize hospitals with high MRSA infection rates by reducing reimbursement. "But as the science evolves, and we discover how to prevent more of these infections, we think that yes, CMS will want to encourage strong performance and discourage poor performance in infection control," Warye says.
She adds that the survey should provide the "most up-to-date understanding of the prevalence of MRSA in U.S. healthcare facilities and whether prevention efforts have been effective since our original survey."
She says the survey results will not identify hospitals that participate in the survey, but may indicate trends for MRSA incidence and control on a state-by-state basis. To get the most accurate picture possible, she says, "We're hoping every hospital in the country will participate."
APIC, based in Washington DC, has more than 13,000 members who direct infection control programs for hospitals and other healthcare facilities.