637Control of Methicillin-Resistant Staphylococcus aureus (MRSA) in Long Term Care is Possible While Maintaining Patient Socialization without Isolation
Year: 2014
Type: conference-abstract
Abstract: Background. To reduce MRSA clinical disease in Long Term Care Facilities (LTCFs), we evaluated a novel program that was minimally invasive and did not interfere with activities of daily living (ADL) or socialization of patient-residents. We hypothesized that reducing MRSA disease without contact precautions is possible and that demonstration of this success could lead to an ongoing relationship between acute care hospitals and LTCFs. Methods. A prospective, cluster-randomized trial was performed in 3 LTCFs over 2 years to reduce MRSA colonization with the goal of lowering MRSA clinical infection. During Year 1 nursing units at the 3 LTCFs were stratified by type of care and randomized to either intervention or control units. In Year 2 all nursing units were converted to intervention that consisted of nasal decolonization of all patient-residents using nasal mupirocin twice daily for 5 days and a chlorhexidine bath. The intervention was repeated at 30 days (i.e., 2 decolonization/ bathing cycles). All units received annual instruction on the importance of hand hygiene as well as enhanced cleaning with bleach wiping of all flat surfaces every 4 months. Concurrently with the start of decolonization and continuing thereafter, all new admissions were screened on site using real-time PCR (Cepheid GeneXpert®) and those positive were decolonized (once) but not isolated. Changes in the rate of MRSA clinical infection for the 2 years of study were compared to the Baseline MRSA clinical infection rate. Results. The overall rate of MRSA infections significantly decreased between the Baseline and Year 2 (table). A significant reduction of MRSA infections was also observed at each of the 3 individual LTCFs (p < 0.03). Clinical MRSA Infections during the three study periods (PD = Patient Days). Conclusion. Active MRSA surveillance with targeted decolonization resulted in a significant decrease in the rate of clinical MRSA infection among LTCF residents without limiting socialization or ADL. Furthermore, developing a formal, contracted relationship between our acute care hospital system and the LTCFs has lead to an ongoing infection prevention interaction beyond control of MRSA. Disclosures. L. Peterson, Cepheid: Investigator, Research grant
Source: Open Forum Infectious Diseases
Institutions: University of Chicago, Endeavor Health, Northwestern University
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,053
OpenAlex ID: W2310728445