Nearly 120,000 people contracted bloodstream staph infections in the United States in 2017, most of them in health care facilities – and nearly 20,000 died.
Progress against the most dangerous antibiotic-resistant staph infections in hospitals stalled after dropping an average of about 17 percent per year from 2005 to 2013, according to data released Tuesday by the Centers for Disease Control and Prevention.
Staph is a common bacteria found on the skin and in the noses of one in four healthy people. It’s usually harmless. But if the skin is damaged or cut, it can cause infection.
MRSA, the more dangerous antibiotic-resistant staph infection, can be spread by bed linens, medical equipment or health care workers if they don’t wash their hands properly between patients. MRSA can cause life-threatening pneumonia and bloodstream infections, which can lead to sepsis and death.
The World Health Organization recommends that all patients be screened for staph infections before surgery. The United States doesn’t require screening for MRSA, and has not developed plans to manage the infection.
Staph infections can be reduced and even eliminated. The most recent data from the Centers for Medicare and Medicaid Services shows that 249 U.S. hospitals had no cases of MRSA during the 12 months from April 2017 through March 2018, according to an analysis by the hospital rating organization Leapfrog Group.
But they’re the exception.
“Unfortunately, only a small faction of hospitals do great and the vast majority are not doing as well as they should be,” says Joe Kiani, CEO of the medical equipment company Masimo and chairman of the board of the Patient Safety Movement Foundation.
Veterans Affairs medical centers reduced staph infections by 43 percent from 2005 to 2017 by implementing a broad MRSA prevention program, the CDC reported. The program included MRSA screening, gloves and gowns on workers, and an increased emphasis on hand-washing and other ways to prevent infections.
Dr. Kevin Kavanaugh, founder of the patient safety advocacy group HealthWatch USA, says the VA results show that more can be done. He notes that the standard of care in England is to search for people who have MRSA but are not sick and to decolonize them.
Dr. Anne Schuchat, CDC’s principal deputy director, said the slowing of progress may be due to hospitals “wondering whether it’s worth their trouble” to take precautions against infection even though “the results speak for themselves.”
But she stopped short of calling for requirements that hospitals screen for MRSA.
“There’s always a balance between intervention and effect,” she told reporters Tuesday.
CDC “strongly recommends” hospitals use the precautions to prevent the spread of MRSA, and take additional steps when “declines slow or progress is not continuing.”
“We don’t have a one size fits all and everybody has to do everything” recommendation, she said.
With so much known about how to prevent MRSA, Leapfrog CEO Leah Binder says, hospitals have to make fighting infection “the absolute priority.”
“Too often they get distracted by other issues,” she says. “MRSA infections can be truly monstrous, and people live in fear of hospitals because MRSA can thrive there.”
Kiani hopes the research will prompt hospitals to adopt protocols and checklists to prevent MRSA.
Zero infections isn’t “something you hope happens,” he says. “You plan for it to happen.”
He recommends tying employee bonuses to infection reduction.
Leapfrog says hospitals should keep MRSA patients separate from other patients and require providers and visitors to wear gloves and gowns around them.
“Anyone who says MRSA can’t be prevented need only look at the hospitals with zero MRSA infections,” says Binder. “Imagine how many lives would be saved if every hospital could get to zero, or even close.”
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