Limiting the Spread

Tracking Resistance

Improving Stewardship

Developing New Solutions

A Cost-Effective Way for Infection Preventionists to Stem Outbreaks and Practice Good Antimicrobial Stewardship

There are two main approaches that hospitals and other healthcare organizations are taking to prevent MRSA infections, particularly among their most vulnerable patient populations. These populations include patients admitted to intensive care units (ICUs), those undergoing surgery, and those transferred from another healthcare facility. The approaches are:

  • Targeted decolonization: perform active MRSA surveillance testing on all patients or select high-risk patient groups and place those who test positive in contact precautions and decolonize them
  • Universal decolonization: treat all patients or select high-risk patient groups with a nasal antibiotic or antiseptic and bathe with the antimicrobial agent chlorhexidine (CHG), without performing surveillance and regardless of their MRSA status

Which method is more effective at preventing MRSA outbreaks in a healthcare facility, and at what cost?

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In order to reduce additional selection pressure in [hospital-acquired] pathogens it seems to make sense to restrict the valuable agent CHG to those indications with a clear patient benefit and to eliminate it from applications without any benefit or with a doubtful benefit."

-Dr. Günter Kampf

References:
Kampf G. Acquired resistance to chlorhexidine—is it time to establish an ‘antiseptic stewardship’ initiative? Journal of Hospital Infection. 2016; 1-15.

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