MRSA Cases Dropping in Hospital ICUs

Prevention efforts have led to declines of up to 70 percent, CDC researchers say

Posted: February 17, 2009

By Steven Reinberg
HealthDay Reporter

TUESDAY, Feb. 17 (HealthDay News) -- Blood infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have dropped significantly in hospital intensive care units, researchers from the U.S. Centers for Disease Control and Prevention report.

MRSA, a type of staph bacteria that's resistant to certain antibiotics, can cause severe infections in people in hospitals and other health-care facilities. It can also cause serious skin infections in healthy people who haven't recently been hospitalized.

The tough-to-treat blood infections have caused the most concern, but the new CDC numbers suggest that hospital prevention efforts may be turning the tide against MRSA.

"The risk of bloodstream infections caused by MRSA that are associated with the use of central line catheters has dramatically declined by 50 to 70 percent since 2001, in all types of adult ICUs," said lead researcher Dr. Deron C. Burton, associate director of CDC's Health Equity National Center for Health Marketing.

A central line is a catheter inserted into a large blood vessel. The tip of the catheter is typically close to the heart or in the aorta or jugular vein.

The drop in these infections is largely due to better procedures that have improved the safety of catheters, Burton said. "There has been improvement in the sterility of how they are inserted and how they are cared for while they are in the patient," he explained.

The report is published in the Feb. 18 issue of the Journal of the American Medical Association.

For the study, Burton's group collected data from hospitals reporting on MRSA infections to the CDC. Specifically, the researchers looked at ICU-based MRSA infections associated with central line catheters from 1997 to 2007.

During that period, 1,684 ICUs reported almost 33,600 central line bloodstream infections. Of these, 7.4 percent were MRSA and 4.7 percent were methicillin-susceptible Staphylococcus aureus (MSSA), meaning the infection could be treated with the antibiotic.

Although the percent of infections attributed to MRSA increased by nearly 26 percent over the period, the actual number of MRSA infections dropped by close to 50 percent, the researchers noted. This overall drop took place after 2001 and continued through 2007, the researchers found.

The decline in MRSA infections was seen in all types of ICUs. For example, infections dropped 51.5 percent in medical-surgical ICUs and by more than 69 percent in surgical ICUs. The number of MRSA infections in pediatric ICUs remained stable, although MRSA infections in these ICUs was already low to begin with, the researchers noted.

Infections from MRSA were not the only ones to decline, Burton said. "We looked at bloodstream infections being caused by any pathogen, not just MRSA. When we looked at all causes of these central line bloodstream infections lumped together, we saw declines of roughly 40 to 50 percent in the risk of these infections," he said.

"Hospitals should be encouraged by these results," Burton said. "Their efforts should be continued and expanded."

The findings are also great news for patients, Burton added. "Central lines have become safer in recent years, at least with the risk of causing bloodstream infections," he said.

Dr. Pascal James Imperato, dean and distinguished service professor of the graduate program in public health at SUNY Downstate Medical Center in New York City, said he was heartened by the findings.

"MRSA central line-associated bloodstream infections were once common," he noted. "The present study is of great significance because of its size and decade-long comparisons. The dramatic declines in bloodstream infections due to MRSA, and associated with central lines in adult patients in intensive care units, reflect the implementation over the past several years of a variety of very effective preventive barrier techniques."

Important among these improvements are changes in central line insertion techniques and the maintenance of such lines. The implementation of techniques in hospitals to prevent the transmission of MRSA between patients has also been invaluable, Imperato added.

"The results of this study demonstrate that when appropriate prevention techniques are scrupulously implemented in the health-care setting, the incidence of MRSA and other forms of infection can be dramatically reduced," he said. "Such preventive measures, now being more aggressively applied in most health-care settings should, hopefully, greatly reduce the incidence of all forms of MRSA infections."

kindly help my boyfriend

im jessilyn maturan of philippines i have boyfriend got m.r.s.a now and he is on tne hospital until now he got his mrsa 4days from now.... hes at the icu pls help my boyfriend i really love him and i dont want to lose him.... plss

jessilyn maturan @ Aug 20, 2009 09:29:52 AM

Your role

What are the 10 most common ways to spread MRSA?

Your fingers! (Your hands!)

MRSA exists both inside and outside of hospitals. Handwashing is one of the most effective ways to prevent the spread, not only of MRSA, but all organisms.

Wash hands with soap and water (antimicrobial gel if that is not available and your hands are not visably soiled) for as long as it takes to sing 'Happy Birthday". Turn the faucet off with a paper towel so you don't recontaminate your clean hands.

If your loved one does have MRSA or another resistent organism, follow infection control guidelines explained to you. If not explained, ask.

Thankfully, not everyone with MRSA is 'sick'. They might harbor the MRSA in their nose (or other site), and that is called colonization. However, we must still prevent the spread as there are people who are compromised and more susceptible to getting quite sick from it.

There are new products on the market with silver ions in them that not only repell organisms but also break the DNA so they can't replicate. Keep your eye out for them as they will soon be in a market near you.

RN of MA @ Feb 23, 2009 21:29:35 PM

MRSA

Sometimes, Death Is Good….. For A Vicious Unicellular Microorganism

There are a variety of different types of foreign bacterial infections one can get from many different sources, yet some are more common than others. If they are not beneficial for your physiology, they all should die in order to restore your health.

Bacteria are a simple life form, yet are incredibly productive and efficient. As with other life forms, it exists to reproduce, and does so about every hour, and evolves and adapts to its environment as needed. To do this, it fully utilizes all available resources and energy to develop the protein that is essential for its survival, and bacteria have the ability to adapt as needed to assure this happens.

It needs exactly 7 genes to produce the essential ribosomes for this to occur. Any more or less genes than 7, the bacteria is not maximizing its efficiency to survive and reproduce. Amazing.

Strept infections are caused by what are called gram positive bacteria, and are the most common bacteria that infect others. Staph bacterial invasions are gram positive as well, yet it is the MRSA, Methicillin Resistant Staff Aureous bacteria of this type often are very difficult to treat normally when a patient suffers from their damage from being invaded by these bacteria.

Another difficult situation is when a patient is infected by VRE, Vancomycin Resistant Enterococci, as well.

These MRSA and VRE pathogenic or disease causing bacteria are the ones that are the most clinically concerning for the health care provider. In most cases, such bacteria invade a resident of a medical institution, and have proved to result in very dangerous infections.

If so, they are called nosocomial infections, and such infections are not limited to resistant strains of bacteria. Greater than 5 percent of nosocomial infections are determined to be MRSA infections, others have determined. This results in about 100,000 serious hospital infections, as well as about 20,000 deaths from MRSA infections annually.

Group A strep infections can cause diseases such as strep throat and pneumonia. Since there are several types of bacteria, a diagnostic test called a culture and sensitivity is usually performed to assure the correct antibiotic is selected for treatment, as the bacteria are identified with this method.

Typically, fluid from the area suspected of being infected is obtained from the patient suspected to have an infection and smeared on what is called a petrie dish. And then these dishes are incubated for 2 to 3 days. Gram positive bacteria stain during this process a dark violet or blue. Gram negative bacteria would be pink in color, and are capable of harm as well to a human being.

When the culture is complete, technology offers recommendations on the appropriate class or brand of antibiotic for this bacteria present in another person- presuming the bacteria will not be resistant to the antibiotic recommended, as this happens on occasion.

Usually, classes of antibiotics that are used to treat gram positive strep infections that are not VRE or MRSA are cephalosporins, macrolides, or general penicillins. If the microbe that is causing the infection is resistant to the antibiotic from such classes that are administered to the infected patient, particularly with methicillin and vancomycin, which is the case with VRE and MRSA bacteria, then there are other more aggressive antibiotics that will be chosen for this patient.

Such brands and types of antibiotics for MRSA and VRE bacteria include Zyvox, which has both IV and oral dosage options. There are also other antibiotics, such as Cubicin. However these antibiotics for antibiotic resistant bacteria are given usually due to infections that have progressed to a more serious nature within a patient infected in such a way.

Progressive medical conditions include sepsis, or blood infection, osteomyelitis, or bone infection, or Pneumonia, which is a serious lung infection. A hospital stay is normally required with such patients, as the last antibiotics mentioned for MRSA and VRE bacterial infections are given by IV administration initially for several days, if not several weeks.

There are numerous classes and types of antibiotics available, yet bacterial resistance to most of these antibiotics constantly remains serious concern for the health care provider, and the infected patient, with MRSA at the top of the list of concerns for the health care providers. Medical institutions should possibly consider quarantine for those patients at their locations that have been determined to be infected with the MRSA bacteria

Dan Abshear

http://www.cdc.gov/ncidod/dhqp/ar_mrsa_spotlight_2006.html

Dan of MO @ Feb 22, 2009 12:51:28 PM

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