Strategies to Prevent Methicillin-ResistantStaphylococcus aureusTransmission and Infection in Acute Care Hospitals: 2014 Update

Abstract

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their methicillin-resistant Staphylococcus aureus (MRSA) prevention efforts. This document updates “Strategies to Prevent Transmission of Methicillin-Resistant Staphylococcus aureus in Acute Care Hospitals,” published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

Effect of daily chlorhexidine bathing on acquisition of carbapenem-resistant Acinetobacter baumannii (CRAB) in the medical intensive care unit with CRAB endemicity

“…21 In case of methicillin-resistant Staphylococcus aureus (MRSA), universal decolonization using daily chlorhexidine bathing alone or in combination with intranasal mupirocin is recommended for use in locations and populations within the hospital that have unacceptably high MRSA rates, despite the implementation of the basic strategies for MRSA transmission and infection prevention (quality of evidence: grade I). 23 Statistical approaches assuming independence of outcomes relating to infection or colonization are inappropriate because for transmission of multidrug-resistant organisms the risk to one patient depends on the status of other patients. Therefore, we performed an interrupted time series study, with a study design that conformed to the Outbreak Reports and Intervention studies Of Nosocomial infection statement to evaluate the effect of daily chlorhexidine bathing on acquisition of CRAB in a medical ICU with CRAB endemicity.…”

Hospitalized Patients with Cirrhosis Should Be Screened for Clostridium difficile Colitis

“…Only patients with diarrhea are recommended to be screened [9]. In contrast, universal and targeted screening for methicillinresistant Staphylococcus aureus (MRSA) in hospitalized patients is recommended by many organizations [10][11][12]. MRSA is associated with increased morbidity and mortality, as well as greater healthcare utilization [13].…”

Comparing visual inspection, aerobic colony counts, and adenosine triphosphate bioluminescence assay for evaluating surface cleanliness at a medical center

“…4,5 Cleaning and disinfecting hospital environments were therefore an important paradigm for preventing microbial colonization and health careeassociated infections. [6][7][8] The Center for Disease Control and Prevention encouraged all hospitals to develop programs for optimizing the thoroughness of high-touch surface cleaning. 9 However, systems to monitor cleaning effectiveness are frequently suboptimal, and there is no consensus regarding the preferred method to judge hospital cleanliness.…”