Strategies to Prevent Methicillin-Resistant Staphylococcus aureus in Acute-Care Hospitals
Key Points
Key Points
- Antimicrobial stewardship is an essential practice for the prevention of methicillin-resistant Staphylococcus aureus (MRSA) in acute-care hospitals.
- Although the use of contact precautions remains an essential practice, hospitals that have strong horizontal prevention measures and neither ongoing MRSA outbreaks nor high or increasing rates of MRSA infection or hospital-onset MRSA-positive cultures may consider modifying the use of contact precautions for some or all MRSA-colonized or MRSA-infected patients.
- Active surveillance testing (AST) for specific patient populations is an additional approach that may be implemented part of a multifaceted strategy to prevent and control MRSA.
- Universal or targeted decolonization in several specific patient populations should be considered when MRSA transmission is not controlled by essential practices.
- This pocket guide highlights practical recommendations to assist acute care hospitals in implementing and prioritizing MRSA prevention efforts.
- It is based on a synthesis of evidence, theoretical rationale, current practices, practical considerations, author consensus, and consideration of potential harm, where applicable.
- No guideline or expert guidance document can anticipate all clinical situations. This pocket guide is not meant to be a substitute for individual clinical judgment by qualified professionals.
Recommendations
...mmendations
...ations to Prevent MRSA (Table 1)...
...l Practices: should be adopted by all acute-care...
...nt a MRSA monitoring program. (L)3305355...
.... Conduct a MRSA risk assessment. (L)330535...
3. Promote compliance with the Centers...
...Use contact precautions for MRSA-colonized and...
5. Ensure cleaning and disinfection o...
...a laboratory-based alert system that notif...
...Implement an alert system that identifie...
...vide MRSA data and outcome measures to key s...
...e healthcare personnel about MRSA. (L)33053...
...atients and families about MRSA. (L)3305355...
...ement an antimicrobial stewardship program. (L)3...
...Approaches: can be considered for...
...ctive Surveillance Test...
1. Implement a MRSA AST program for se...
...tive surveillance for MRSA in conjunction...
...Active surveillance with contact precautions is i...
...tal-wide active surveillance for MRSA...
...tive surveillance can be performed in the sett...
...HCP for MRSA infection or colonizati...
...reen HCP for MRSA infection or colon...
...lonization therapy...
...niversal decolonization (daily chlorhexidine...
...preoperative nares screening with...
...MRSA and provide targeted decolonization w...
...HG bathing plus nasal decolonization to known...
...Consider postdischarge decolonization of MRSA ca...
...ICUs should consider targeted or un...
...Burn units should consider targeted or univ...
...r targeted or universal decolonization of...
...onsider decolonization as part of a mult...
...niversal use of gowns...
...s and gloves when providing care to or entering t...
...nresolved Issues...
...SA decolonization Mupirocin and chlor...