MRSA Cases Decline Across Veterans Health Administration Facilities Nationwide

Findings from a recently published study indicate that infection prevention efforts in the country’s Veterans Affairs (VA) health facilities have effectively led to a reduction in methicillin-resistant Staphylococcus aureus (MRSA) cases.

The majority of MRSA cases in the United States are healthcare-associated, according to national estimates from the Centers for Disease Control and Prevention (CDC). Hospital and nursing home patients, particularly those with surgical wounds, are at heightened risk of contracting these antibiotic-resistant skin and soft tissue infections along with more serious problems such as sepsis, pneumonia, and bloodstream infections. MRSA, a serious drug-resistant bacterium, causes more than 80,000 severe infections each year, and most often during or soon after medical inpatient care. These infections also lead to an estimated 11,285 deaths, annually.

Efforts to reduce the rate of healthcare-associated infections from antibiotic-resistant pathogens in US medical facilities have included antibiotic stewardship and initiatives to increase hand hygiene compliance. One recent study found that implementing new infection control measures at Veterans Health Administration (VHA) facilities around the country, helped reduce the rate of infections from Escherichia coli, Klebsiella species, and Pseudomonas aeruginosa by more than 43%. Now, findings from a new study published in the American Journal of Infection Control, show that the Department of Veterans Affairs' campaign to limit healthcare-associated infections at VHA facilities has dramatically reduced the incidence of MRSA in patients.

The new study’s authors examined data collected from VA medical centers across the United States between October 2007 and September 2015, from both intensive care unit (ICU) and non-ICU records. This included data from 127 ICUs, 22 facilities with spinal cord injury units, and 133 long term-care facilities, and measured a total of 23,153,240 patient-days. During this study period, the VA implemented its MRSA Prevention Initiative, a policy created to reduce the number of MRSA transmissions and infections in those served by the VHA. The initiative focused on the main sources of bacterial trasnmission: patients’ hands, healthcare workers, and contact with contaminated inanimate objects.

During the course of the study, the researchers found that the percentage of patients screened for MRSA colonization or infection at admission increased from 83.3% in April 2008 to 94.8% in September 2015, and that at discharge, swabbing compliance increased from 67.0% to 90.5% over the same time period. Overall, during the study period, monthly healthcare-associated infection rates dropped by 87% in ICUs, 80.1% in non-ICUs, and 80.9% in spinal cord injury units. In long-term care facilities, infection rates fell by 49.4% from July 2009 to September 2015. Only two cases of MRSA infection were reported in ICUs, while 20 were reported in non-ICUs, and 31 in long-term care facilities nationwide during the last month of the study. The study’s authors attributed the decreased rate of MRSA and other infections to the initiative interventions, including patient surveillance during admission, transfers between units, and at discharge, along with better contact precautions for those colonized or infected with MRSA, and an emphasis on hand hygiene.

“Understanding how and why rates of MRSA have diminished in recent years is essential for the continued progress of effective prevention programs,” said the study’s lead author Martin E. Evans, MD, in a recent press release. “As we seek to protect patients from MRSA and other resistant organisms, our study supports the need for strong infection prevention programs at every healthcare facility.”