Incidence of Central-line MRSA Infections on the Decline

MRSA central line-associated blood stream infections occurring in intensive care unit (ICU) patients decreased by almost 50% between 1997 and 2007, a new study has found.

Nearly 1,700 ICUs were examined throughout the decade-long study, which was published in JAMA and authored by the Centers for Disease Control and Prevention.

Overall, nearly 33,600 central line-associated bloodstream infections (BSI) were reported, less than fifteen percent of which were MRSA or methicillin-susceptible S aureus (MSSA). According to the JAMA abstract, “percent MRSA was defined as the proportion of S aureus central line-associated BSIs that were MRSA.”

The study examined seven different types of ICUs: surgical, non-teaching-affiliated medical-surgical, cardiothoracic, coronary; medical, teaching-affiliated medical-surgical, and pediatric units.

Of these different units, rates of MRSA central line-associated BSIs declined “significantly” in all units expect pediatric ones, where incidences remained the same.

Rates of MRSA decrease went from “—51.5% (95% CI, –33.7% to –64.6%; P < .001) in nonteaching-affiliated medical-surgical ICUs (0.31 vs 0.15 per 1000 central line days) to –69.2% (95% CI, –57.9% to –77.7%; P < .001) in surgical ICUs (0.58 vs 0.18 per 1000 central line days),” according to the JAMA abstract.

Incidences of MSSA declined in every one of the seven units examined.

Decreases in MSSA cases ranged from “—60.1% (95% CI, –41.2% to –73.1%; P < .001) in surgical ICUs (0.24 vs 0.10 per 1000 central line days) to –77.7% (95% CI, –68.2% to –84.4%; P < .001) in medical ICUs (0.40 vs 0.09 per 1000 central line days).”

“This is encouraging news for patients and the healthcare community,” said Kathy Warye, CEO of the Association for Professionals in Infection Control and Epidemiology, in a release on the group’s website. “While central line-associated blood stream infections caused by MRSA represent only a small fraction of the overall number of MRSA infections, this analysis demonstrates that healthcare-associated infections can be prevented in a very vulnerable group of patients when institutions consistently implement evidence-based prevention strategies.”

specialty: hospital medicine