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New strategies to combat MRSA in hospitals


Infection prevention and control guidance prioritizes strategies

New guidelines aim to reduce the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), improve patient safety and prioritize current prevention efforts underway in hospitals. This drug resistant bacterium is a common source of patient morbidity and mortality in U.S. hospitals, causing nearly twice the number of deaths, significantly longer hospital stays and higher hospital costs than other forms of the bacteria.

The strategies were published in the July issue of Infection Control and Hospital Epidemiology and produced in a collaborative effort led by the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, the American Hospital Association, the Association for Professionals in Infection Control and Epidemiology, and The Joint Commission.

"Many hospitals have made inroads in preventing healthcare-associated MRSA through essential prevention strategies, but some hospitals need additional intervention," said David Calfee, MD, MS, co-lead author of the guidelines with Cassandra Salgado, MD, MS. "This guidance provides a roadmap for prioritizing and implementing strategies."

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Key highlights from the guidelines include:

  • Conduct an MRSA risk assessment: During the assessment, two important factors to focus on include the opportunity for MRSA transmission (i.e. number of patients who are MRSA carriers and produce risk for transmission) and estimates of facility-specific MRSA burden and rates of transmission and infection (i.e. the ability of facility's current activities to contain MRSA).
  • Implement an MRSA monitoring program and track rates: Goals of the program should focus on identifying any patient with a current or prior history of MRSA and provide mechanism for tracking hospital-onset cases of the infection. Alerts should be sent out from laboratory to notify HCP of new colonization or cases of MRSA.
  • Ensure compliance on hand hygiene recommendations: Healthcare personnel should perform hand hygiene in accordance with CDC or World Health Organization recommendations.
  • Ensure compliance with contact precautions for MRSA-colonized and infected patients: Patients colonized with MRSA should be separated from the general patient population and HCP should wear gloves and gowns when interacting with this patient population to prevent the spread of the bacteria.
  • Ensure proper cleaning and disinfection of equipment and environment: Because contamination can be widespread among the patient's environment, optimal cleaning and disinfection procedures should be employed.
  • Educate healthcare personnel, patients and families about MRSA: Personnel, patients and families should be made aware of risk and their role in prevention, transmission and recommended precautions.
  • Implement an alert system: Notification of laboratory-identified or readmitted patients with MRSA should be instituted to provide timely information and allow prompt initiation of control measures.

"There is no "one-size-fits-all" approach to improving practices. Local contextual factors matter when implementing strategies," said Edward Septimus, MD, an author of the commentary, Approaches for Prevention Healthcare-Associated Infections: Go Long or Go Wide, also published in the July issue.

The new practice recommendations are a part of Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates, a series of articles to be published over several months sharing evidence-based strategies to help healthcare professionals effectively control and prevent the spread of healthcare-associated infections (HAIs). The 2014 release revises the initial 2008 Compendium publication.


David Calfee, Cassandra Salgado, Aaron Milstone, Anthony Harris, David Kuhar, Julia Moody, Kathy Aureden, Susan Huang, Lisa Maragakis, Deborah Yokoe. "Strategies to Prevent Methicillin-Resistant Staphylococcus aureus Transmission and Infection in Acute Care Hospitals: 2014 Update." Infection Control and Hospital Epidemiology 35:7 (July 2014)

Published through a partnership between the Society for Healthcare Epidemiology of America and The University of Chicago Press, Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 13 out of 158 journals in its discipline in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

About the Society for Healthcare Epidemiology of America

SHEA is a professional society representing more than 2,000 physicians and other healthcare professionals globally with expertise in and passion for healthcare epidemiology and infection prevention. SHEA's mission is to prevent and control healthcare-associated infections and advance the field of healthcare epidemiology. The society promotes science and research, develops expert guidelines and guidance for healthcare workers, provides high-quality education, promotes antimicrobial stewardship, encourages transparency in public reporting related to HAIs, works to ensure a safe healthcare environment, and facilitates the exchange of knowledge. SHEA upholds the value and critical contributions of healthcare epidemiology to improving patient care and healthcare worker safety in all healthcare settings. Visit SHEA online at, and @SHEA_Epi.

About the Infectious Diseases Society of America

The Infectious Diseases Society of America (IDSA) is an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, prevention, and patient care. The Society, which has more than 10,000 members, was founded in 1963 and is based in Arlington, VA. For more information, see

About the American Hospital Association

The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the improvement of health in their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks and other providers of care. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information visit the website at

About the Association for Professionals in Infection Control and Epidemiology

APIC's mission is to create a safer world through prevention of infection. The association's more than 15,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at Follow APIC on Twitter: and Facebook: For information on what patients and families can do, visit APIC's Infection Prevention and You website at

About The Joint Commission

Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission evaluates and accredits more than 20,000 health care organizations and programs in the United States, including more than 10,300 hospitals and home care organizations, and more than 6,500 other health care organizations that provide nursing and rehabilitation center care, behavioral health care, laboratory and ambulatory care services. The Joint Commission currently certifies more than 2,000 disease-specific care programs, focused on the care of patients with chronic illnesses such as stroke, joint replacement, stroke rehabilitation, heart failure and many others. The Joint Commission also provides health care staffing services certification for more than 750 staffing offices. An independent, not-for-profit organization, The Joint Commission is the nation's oldest and largest standards-setting and accrediting body in health care. Learn more about The Joint Commission at

Tamara Moore | Eurek Alert!

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