Saturday, July 27, 2013

Researchers say all ICU patients should be disinfected to stop MRSA spread

Research on strategies for reducing hospital infections received extensive coverage in print, in some of the most widely-circulated papers in the US, and online, although no national television news broadcasts featured the story. Many sources quote CDC officials, some of whom were involved in the study, which was funded by the Agency for Healthcare Research and Quality and the CDC. Most articles, and researchers quoted therein, point out that the strategy infection-reduction described in the study could have immediate implications.
        The Washington Post (5/30, Sun, 489K) reports, “Using germ-killing soap to wash” all patients in the intensive-care unit “every day and applying antibacterial ointment inside their noses turns out to be the most effective way to reduce deadly hospital bloodstream infections, according to a study, published” in the New England Journal of Medicine, “that has broad implications for practical use.” Investigators “found that daily application of mupirocin ointment inside the nose and daily washing with a cloth soaked in chlorhexidine soap reduced bloodstream infections by up to 44 percent and significantly reduced the presence of drug-resistant bacterium known as MRSA, or methicillin-resistant Staphylococcus aureus.” The Post points out that “CDC Director Tom Frieden said the agency is weighing the findings for possible inclusion in CDC’s infection prevention recommendations.” The Post also provides a video in which Frieden discusses the findings.
        The New York Times (5/30, O'Connor, 1.68M) “Well” blog points out that “most hospitals currently use a more limited approach, which involves screening intensive care patients and then isolating those known to harbor MRSA.”
        The Wall Street Journal (5/30, Landro, Subscription Publication, 2.29M) reports that the study included researchers from the Agency for Healthcare Research and Quality. AHRQ Director Carolyn Clancy said that, being that a large number of hospitals have already started screening patients for MRSA, “it may take some time for the medical community to assess the degree to which the study findings should eliminate this practice.”
        The Los Angeles Times (5/30, Brown, 692K) “Science Now” blog reports that in an accompanying editorial, Drs. Michael B. Edmond and Richard P. Wenzel of the division of infectious diseases at the Virginia Commonwealth University School of Medicine in Richmond “suggested that hospitals should discontinue screening and isolating patients for MRSA control.” However, “they, and the study authors, also cautioned that hospitals would need to assess whether universal treatment would contribute to resistance to chlorhexidine and mupirocin.”
        The NPR (5/30, Stein) “Shots” blog reports that the editorialists also “said the study illustrates the ‘folly of pursuing legislative mandates when evidence is lacking.’ State laws mandating MRSA screening should be repealed, they say.”
        Bloomberg News (5/30, Cortez) reports that “the finding should have immediate implications...said” lead researcher Susan Huang. According to Huang, “I really believe that this should be adopted by many, if not most hospitals as a way to reduce infections from all pathogens, not just these superbugs.”
        The AP (5/30, Tanner) reports that Clancy “said the findings have ‘the potential to influence clinical practice significantly and create a safer environment where patients can heal without harm.’”
        CQ (5/30, Subscription Publication) reports, “A total of 74 adult ICUs and 74,256 patients were part of the study, making it the largest study on this topic, CDC officials said.” Also covering the story are the Tampa Bay (FL) Times (5/30, Stein), Modern Healthcare(5/29, Zigmond, Subscription Publication, 71K), Tennessean (5/30, Wilemon, 120K), HealthDay (5/30), and MedPage Today (5/30, Phend).

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