IDWeek 2019 — MRSA decolonization protocol decreases bacteremia


  • Devona Williams, Pharm.D.
  • Conference Reports
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Takeaway

  • Initiation of a decolonization protocol of skin and nares resulted in decreased methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in high-risk adult patients.

Why this matters

  • Patients with identified clinical and environmental factors are at higher risk of MRSA bacteremia.
  • Decreasing MRSA colonization can help promote infection control practices in health systems and improve individual patient outcomes.

Study design

  • Single-center, retrospective chart review of high-risk patients to determine effect of decolonization protocol on MRSA bacteremia.
  • The decolonization protocol consisted of daily chlorhexidine gluconate bathing in combination with twice daily antiseptic swabbing of the nasal cavities using 10% povidone-iodine or (for pregnant or iodine-allergic patients) Nozin nasal sanitizer antiseptic.
  • High-risk patient characteristics included the following: MRSA colonized, elective surgery, ICU admission, intravenous drug users, dialysis patients, incarceration, and hospital admission in the prior 30 days.

Key results

  • An estimated 2000 nasal decolonizations and 1000 chlorhexidine baths were performed during the study period.
  • There was a strong correlation to decreased rates of hospital-onset MRSA bacteremia with increased compliance with the MRSA decolonization bundle (R2 =0.785).

Limitations

  • Single-center, retrospective chart review.
  • Results presented at a conference, and data not peer-reviewed.