What CDC is Doing to Combat MRSA
Reducing MRSA infections is a CDC priority. CDC and U.S. Department of Health and Human Services are working with healthcare facilities to meet the goals in the 2013 National Action Plan to Prevent Healthcare-Associated InfectionsExternal and reduce bloodstream infections caused by MRSA by 50% by 2020 using the 2015 baseline.
To protect people from MRSA, CDC works to
- prevent infections;
- prevent spread of the germ; and
- improve antibiotic use, which can slow the development of resistance.
CDC scientists track the number and kind of MRSA infections throughout the country using complementary systems. Together, these systems give CDC, other Federal agencies such as Centers for Medicare & Medicaid Services (CMS), health departments, and healthcare facilities information to better understand where MRSA infections are happening, the types (strains) of staph bacteria that are causing these, and where to put resources to help stop infections.
- National Healthcare Safety Network (NHSN) Reports
Information sent from healthcare facilities to NHSN allows CDC to determine how healthcare facilities overall are performing against national infection prevention goals. It also allows CDC, health departments and facilities the ability to identify, report, and help specific facilities and units with high infection rates.
- Emerging Infections Program (EIP)
Using information from several locations throughout the country, CDC estimates the national burden of MRSA and can identify people most at risk. This system includes MRSA infections that happen in both the communities and in healthcare facilities. CDC has previously reported on declines in invasive MRSA incidence and other reports have suggested that during this time US MRSA strain epidemiology has changed. The CDC Emerging Infections Program looked at invasive MRSA bloodstream infection trends by strain type and healthcare exposure in a subset of their surveillance region. They found that most of the decline in MRSA bloodstream infections was from decreases in strains that traditionally have been closely associated with healthcare exposure risk, whereas outside of the hospital no change was found in incidence of the dominant strain that causes infections in the community, called USA300. The authors concluded that methods to prevent MRSA bloodstream infections from the USA300 strain will be needed to further reduce burden from MRSA bloodstream infections.
- Electronic health records (EHR)
CDC collaborates with EHR databases from more than 400 U.S. acute care hospitals to describe infection trends and monitor progress.
CDC supports activities to better understand how to detect, prevent, and respond to MRSA and protect people from MRSA infections. Some of the CDC-supported projects include:
- REDUCE MRSA
CDC’s Prevention Epicenters studied the use of decolonization with chlorohexidine and mupirocin, which can be used to reduce the amount of MRSA on patients carrying it, in intensive care units (ICUs) in 43 U.S. hospitals. The study found that universal use in these ICUs reduced MRSA by 37%. The study is continuing to investigate if other methods for decolonization can be as effective.
- ABATE Study
CDC’s Prevention Epicenters also studied the use of chlorohexidine in all patients and chlorohexidine and mupirocin for patients known to have MRSA and compared it with routine bathing. The chlorohexidine and chlorohexidine-and-mupirocin combination reduced MRSA by at least 30%.
- Project CLEAR
Another CDC Prevention Epicenter randomized controlled clinical trial investigated infection rates in patients discharged from the hospital with hygiene education versus patients discharged from the hospital with hygiene education and serial decolonization over 6 months (an effort to reduce the amount of MRSA a person carries). Patients who were educated and decolonized had 30% fewer MRSA infections in the one year following discharge.
- The University of California Irvine
Patients sometimes carry MRSA without showing signs of it (colonization) and may suffer infections from the strain later. This 2018 one-year study will evaluate what percent of MRSA carriers being discharged from hospitals have a community-associated strain. This study will also assess what percent of patients carrying the community MRSA variant develop infection within a year of discharge. Finally, this project will assess whether a repeated decolonization treatment can reduce post-discharge infections due to this strain.
- Rush University Medical Center
In this 2018 one-year study, researchers will use whole genome sequencing (WGS) to examine historical MRSA clinical isolates from the Cook County Health and Hospitals System in Chicago, IL. The objective of this study is to use WGS along with epidemiologic data to better understand the spread of MRSA between healthcare and community settings, with an ultimate goal to identify potential interventions that can prevent infections.
Through the Antibiotic Resistance (AR) Solutions Initiative, CDC supports every state, some large cities, and Puerto Rico to rapidly detect and prevent spread of infections, like MRSA. With 2017 funding:
- Kentucky supported the investigation of an outbreak of MRSA joint infections in patients who received injections at an outpatient orthopedic clinic. Recommendations were made to address observed breaches in infection control and concerns with medication combinations, and no further cases were identified.
- New Mexico responded to an increase in positive MRSA cultures in a NICU (a hospital unit that cares for newborns) by evaluating bed location and patient movement, testing isolates, providing comprehensive recommendations, launching an educational campaign, and conducting enhanced surveillance. Follow up showed no new cases.
- Pennsylvania collaborated with a local jurisdiction to respond to 9 cases of invasive MRSA related to injection-related infection control breaches in an outpatient clinic. Immediate remediation prevented further cases and led to improvements in infection control practices.
- South Carolina effectively responded to five cases of Staphyloccocus aureus in a NICU. Facility infection control practices were observed and recommendations were made and implemented. No further cases were identified.
- Virginia responded to two fatal cases of invasive MRSA infections in a NICU by issuing recommendations for enhanced surveillance, screening staff, and increased environmental cleaning. This generated awareness of the mortality associated with invasive MRSA infections and the importance of reporting.
CDC partners with state health departments to track MRSA infections, promote MRSA prevention, and respond to MRSA outbreaks in healthcare settings.
- MRSA Surveillance through the National Healthcare Safety Network
- Invasive Staphylococcus (MRSA/ MSSA) Infection Tracking through the Emerging Infections Program
- MRSA Baseline Prevention Practices Assessment Tool For States Establishing HAI Prevention Collaborative Cdc-pdf[PDF – 7 pages]
More about CDC surveillance programs and reports related to MRSA: