MRSA

May 2010 Results of VA MRSA Prevention Initiative View Results View VHA 2007-002 Directive on MRSA Prevention Protocol View VHA 2010-006 Directive on MRSA Prevention Protocol

Nov 2009 On Feb 2009 J. of Bone reports that the incidence of MRSA surgical site infections is higher in MRSA carriers. View Abstract

Nov 2009 On July 17th, 2009 The New Mexico MRSA Collaborative reports a 48% reduction in hospital associated MRSA with the implementation of active surveillance cultures and appropriate MRSA control measures for MRSA positive patients. View News Release

Aug 2009: New Cost Estimates published by the CDC for HAI View Report

July 2009: Expert Organizations (APIC, SHEA, IDSA & CSTE) officially support public reporting of hospital acquired infections. View Support Letter View Public Reporting of HAI Section in HR 3200

Jan 2009: Courier Journal. Discussion and Coverage of HB 67 which requires reporting of Hospital Acquired Infections (HAI) and MRSA. View News Article View Bill - HB67

Jan, 2009: National trends in pediatric Staphylococcus Aureus infections of the head and neck was published in the Archives of Otolaryngology. http://archotol.ama-assn.org/cgi/content/abstract/135/1/14 The prevalence of MRSA (Methacillin-resistant Staph Aureus) prevalence increased from 11.8% in 2001 to 28.1% in 2006. A more than doubling of the incidence of this infection. 60% of the pediatric infections were community acquired. (Remember community acquired can still be healthcare associated.) In this study, 46% of Community Acquired MRSA was resistant to Clindamycin compared to only 3% reported by Naimi, et al., in 2001.

Jan., 2009: The US Dept of Health and Human Services has release a draft action plan to prevent healthcare-associated infections. http://www.hhs.gov/ophs/initiatives/hai/draft-hai-plan-01062009.pdf

Several interesting statements are contained in this report:
"Another approach CMS has adopted as it transforms the Medicare program from a passive payer towards the goal of being an active purchaser of higher quality, more efficient health care is hospital pay-for-reporting."

"Public reporting enhances accountability in healthcare by increasing the transparency of quality data. Public reporting is designed to create both “indirect” financial and non-financial incentives to improve quality of care. Indirect financial incentives result when pubic reporting drives patients’ choices and, therefore, market share. Non-financial incentives include publicizing performance, reputations, competition, motivation, accountability, and public, recognition."

Sept, 2008: GAO report on HAI was released (see enclosure) the report's summery states that reporting and definitions are standardized through the National Nosocomial Infections Surveillance (NNIS) system but questions if every hospital's can be relied upon to produce accurate data. View Report

March, 2008: A newly released study by Robicsek and colleagues in the Annuals of Internal Medicine (March 18, 2008), describes the impact of a universal MRSA screening program for patients newly admitted to the hospital. The intervention was associated with an impressive hospital wide 70% reduction in hospital-associated MRSA infections. -- Click Here to View Report.

JAMA recently published a study ( Harbarth et. al. 2008 )last week that allegedly showed that screening patients for MRSA was not an effective prevention strategy. However there were severe flaws in the handling of identified patients. Editorial Analysis by JAMA

Analysis by Consumer Reports found: "Another study published recently in the Journal of the American Medical Association concluded that MRSA screening of surgical patients was not effective for preventing surgical infections. However, this study did not measure the impact on the spread of infections throughout the hospital, rather it only measured infections among the surgical patients screened. The study revealed that the results of 31 percent of the patients' tests were not received prior to their surgery, thus negating the benefit of screening. Further, the study actually found those patients who were pre-screened and who got results prior to surgery, were able to receive the appropriate preventive antibiotics for MRSA and to "decolonize" prior to surgery. In this group, no infections occurred."