MRSA Decreases in Intensive Care Units

Study Shows MRSA Infection Is Down Among Patients Who Have Central-Line Catheters

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Feb. 17, 2009 -- The incidence of potentially dangerous MRSA bloodstream infections associated with intensive care units in the U.S. has been decreasing, a new study shows.

That's contrary to a widespread perception that MRSA infections associated with central-line catheters in intensive care units (ICUs) have been increasing. It is common for the critically ill patients to have central-line catheters placed into large blood vessels in order to administer medications and fluids, draw blood for testing, or help monitor them.

The study is published in the Feb. 18 edition of The Journal of the American Medical Association.

MRSA (methicillin-resistant Staphylococcus aureus) is a staph bacterium that that is resistant to certain antibiotics, making the infection difficult to treat and potentially life threatening.

But CDC researchers say that rather than increasing, the incidence of ICU MRSA bloodstream infections associated with central-line catheters decreased about 50% from 1997 to 2007.

"The emergence of MRSA in health care settings has drawn the attention of clinicians, public health agencies and the public and has prompted calls for mandatory screening or reporting" to reduce infections, the researchers write.

Despite such worries, there has been a dearth of data about the scale of the problem, according to researcher Deron Burton, MD, JD, MPH, and CDC colleagues.

Intensive care units reported 33,587 central-line-associated bloodstream infections between 1997 and 2007, the researchers say. Of those, 2,498 (7.4%) were MRSA infections.

Although the overall percentage of central bloodstream staph infections due to MRSA increased 25.8% in the decade analyzed, the researchers say the overall incidence rate declined 49.6%.

The decreases, they say, may be attributable to efforts by health care providers to improve adherence to CDC guidelines aimed at fighting MRSA.

The findings stand "in sharp contrast" to perceptions based on insufficient information about the MRSA problem, the researchers say in a news release. The new analysis, they contend, suggests that efforts to prevent MRSA infections are succeeding, though "further study is needed" in other patient populations.

Michael William Climo, MD, of the Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Va., says in an accompanying editorial that the new report provides key lessons for patient safety.

He says it's clear that many ICUs have taken steps to abide by CDC guidelines and have made "substantial progress" in reducing hospital-acquired MRSA infections. Still, he adds, better outcomes are within reach.

WebMD Health News Reviewed by Louise Chang, MD on February 17, 2009



News release, The Journal of the American Medical Association.

Burton, D. The Journal of the American Medical Association; Feb.18 2009; vol 301: pp 727-736.

Climo, M. The Journal of the American Medical Association, Feb.18, 2009; vol 301: pp 772-773.

WebMD Health News: "Hospital MRSA Testing Helps After All?"

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