VA MRSA initiative sustained and exceeded initial success, study shows

A multipronged prevention initiative previously credited with significantly reducing rates of methicillin-resistant Staphylococcus aureus in Veteran's Affairs hospitals has sustained those gains over two additional years, according to a study published Tuesday in the American Journal of Infection Control.

Launched in 2007, the VA MRSA Prevention Initiative was associated with a 62% drop in MRSA infection rates in ICUs and a 45% decline in non-ICU settings during the first three years the program was in place. MRSA transmission rates fell 17% in ICUs and 21% in non-ICUs, according to initial results released in 2011.

That news was good but today's news is even better. Over the course of the next 24 months, from July 2010 through June 2012, VA hospitals maintained—and in some cases exceeded—those earlier MRSA reductions. Over the entire 57 months of the initiative, MRSA healthcare-associated infections in ICUs declined 71.9%, while non-ICU infections fell 65.5%. ICU and non-ICU transmissions fell by 21.8% and 24.7%, respectively.

“The analysis presented here shows that, over the ensuing 24 months, MRSA transmissions and MRSA HAI rates continued to decrease nationwide,” the authors wrote in the new study.

MRSA is a bacterium that causes many types of antibiotic-resistant infections. It is the common cause of many surgical-site and bloodstream infections in hospitals and linked to thousands of patient deaths per year, according to federal data.

The VA initiative required participating hospitals to implement a set of best practices, including nasal surveillance for MRSA, improved hand hygiene protocols and contact precautions for patients colonized or infected with MRSA. Additionally, the campaign emphasized the need to change hospital culture and redefine infection control as a shared responsibility.

The results are encouraging, given mounting concerns about the fast growth of antibiotic-resistant infections. In a 2012 study, University of Chicago researchers found that MRSA rates at academic medical centers doubled from 2003 to 2008.

Additional MRSA findings, released this week, brought less hopeful news.

Cases of musculoskeletal MRSA infections in children are on the rise, according to an abstract presented at the American Academy of Pediatrics annual conference in Orlando, Fla. The percentage of pediatric musculoskeletal staph infections classified as MRSA increased from 9% to 29% between 2001 and 2010 at the Children's Hospital of Philadelphia. Such infections were associated with longer lengths of stay and complications such as septic shock.

“Optimizing patient outcomes will require increased healthcare provider vigilance, early broad-spectrum antibiotic administration and aggressive surgical management,” said lead author Eric Sarkissian in an AAP news release.

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