A review of epidemiological studies on the incidence of MRSA infections overtime was performed along with an analysis of data available for download from Hospital Compare (https://data.medicare.gov/data/hospital-compare). We found the estimations of the incidence of MRSA infections varied widely depending upon the type of population studied, the types of infections captured and in the definitions and terminology used to describe the results. We could not find definitive evidence that the incidence of MRSA infections in U.S. community or facilities is decreasing significantly. Of concern are recent data reported to the National Healthcare Safety Network (NHSN) on MRSA bloodstream infections which indicate that by the end of 2015 there had been little change in the average facility Standardized Infection Ratio (0.988), compared to a 2010–2011 baseline and is significantly increased compared to the previous year. This is in contradistinction to the recent Veterans Administration study which reported over an 80% reduction in MRSA infections. However, this discrepancy may be due to the inability to reconcile the baselines of the two data sets; and the observed increase may be artifactual due to aberrations in the NHSN tracking system. Our review supports the need for implementation of a comprehensive tracking and monitoring system involving all types of healthcare facilities for multi-drug resistant organisms, along with concomitant funding for both staff and infrastructure. Without such a system, determining the effectiveness of interventions such as antibiotic stewardship and chlorhexidine bathing will be hindered.
McNeill R, Nelson DJ, Abutaleb Y. ‘Superbug’ scourge spreads as U.S. fails to track rising human toll. Reuters Investigates. Sept. 7, 2016. Retrieved on Mar. 30, 2017 from: http://www.reuters.com/investigates/special-report/usa-uncounted-surveillance/.
Klevens RM, Morrison MA, Nadle J, Petit S, Gershman K, Ray S, Harrison LH, Lynfield R, Dumyati G, Townes JM, Craig AS, Zell ER, Fosheim GE, McDougal LK, Carey RB, Fridkin SK. Active bacterial core surveillance (ABCs) MRSA investigators. Invasive methicillin-resistant staphylococcus aureus infections in the United States. JAMA. 2007;298(15):1763–71. CrossRefPubMed
Kallen AJ, Mu Y, Bulens S, Reingold A, Petit S, Gershman K, Ray SM, Harrison LH, Lynfield R, Dumyati G, Townes JM, Schaffner W, Patel PR, Fridkin SK. Active bacterial core surveillance (ABCs) MRSA investigators of the emerging infections program. Health care-associated invasive MRSA infections, 2005-2008. JAMA. 2010;304(6):641–8. doi: 10.1001/jama.2010.1115. CrossRefPubMed
Dantes R, Mu Y, Belflower R, Aragon D, Dumyati G, Harrison LH, Lessa FC, Lynfield R, Nadle J, Petit S, Ray SM, Schaffner W, Townes J, Fridkin S. Emerging infections program–active bacterial core surveillance MRSA surveillance investigators. National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011. JAMA Intern Med. 2013;173(21):1970–8. doi: 10.1001/jamainternmed.2013.10423. PubMed
Iwamoto M, Mu Y, Lynfield R, Bulens SN, Nadle J, Aragon D, Petit S, Ray SM, Harrison LH, Dumyati G, Townes JM, Schaffner W, Gorwitz RJ, Lessa FC. Trends in invasive methicillin-resistant Staphylococcus aureus infections. Pediatrics. 2013;132(4):e817–24. doi: 10.1542/peds.2013-1112. Epub 2013 Sep 23. CrossRefPubMed
Dudeck MA, Weiner LM, Malpiedi PJ, et al. Risk Adjustment for Healthcare Facility-Onset C. difficile and MRSA Bacteremia Laboratory-identified Event Reporting in NHSN. Published March 12, 2013. Retrieved on Mar. 30, 2017 from: http://www.cdc.gov/nhsn/pdfs/mrsa-cdi/RiskAdjustment-MRSA-CDI.pdf.
Kavanagh KT. Multi-Drug Resistant Organisms - Reporting and Health Dept. Engagement. Kentucky Joint House and Senate Health and Welfare Committee Meeting. 2016.
National Targets and Metrics. Office of Disease Prevention and Health Promotion. Retrieved on Mar. 30, 2017 from: http://www.healthwatchusa.org/downloads/BaseineForMRSA-2013Goal-2010-2011.pdf.
Landrum ML, Neumann C, Cook C, Chukwuma U, Ellis MW, Hospenthal DR, Murray CK. Infectious disease service, San Antonio Military Medical Center, Fort Sam Houston, Texas 78234, Epidemiology of Staphylococcus aureus blood and skin and soft tissue infections in the US military health system, 2005-2010. JAMA. 2012;308(1):50–9. CrossRefPubMed
Evans ME, Kralovic SM, Simbartl LA, Jain R, Roselle GA. Eight years of decreased methicillin-resistant staphylococcus aureus health care-associated infections associated with a Veterans affairs prevention initiative. Am J Infect Control. 2017;45(1):13–6. doi: 10.1016/j.ajic.2016.08.010. CrossRefPubMed
Huang SS, Septimus E, Kleinman K, Moody J, Hickok J, Avery TR, Lankiewicz J, Gombosev A, Terpstra L, Hartford F, Hayden MK, Jernigan JA, Weinstein RA, Fraser VJ, Haffenreffer K, Cui E, Kaganov RE, Lolans K, Perlin JB, Platt R; the CDC Prevention Epicenters Program; the AHRQ DECIDE Network and Healthcare-Associated Infections Program. Targeted versus Universal Decolonization to Prevent ICU Infection. N Engl J Med. 2013 May 29. [Epub ahead of print] Retrieved on Mar. 30, 2017 from: http://www.ncbi.nlm.nih.gov/pubmed/23718152.
U.S. Dept. of Health and Human Services. National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination. Retrieved on Mar. 30, 2017 from: https://health.gov/hcq/prevent-hai-action-plan.asp.
Huang S, Platt R, Septimus E, Weinstein R, Hayden M, Jernigan J. Universal ICU Decolonization: An Enhanced Protocol. Rockville, MD: Agency for Healthcare Research and Quality; 2013. Accessed Mar. 30, 2017 from: https://www.ahrq.gov/sites/default/files/publications/files/universalicu.pdf.
Jernigan J. Infection prevention best practices – lessons learned and gaps. President advisory council on combating antibiotic resistant bacteria. 2017. Webcast accessed Mar. 30 2017 from: https://www.youtube.com/watch?v=PKknYposyQ4&list=PLrl7E8KABz1ETDRg6lSIBbn2q0U5M-vz_&index=2
- The incidence of MRSA infections in the United States: is a more comprehensive tracking system needed?
Kevin T. Kavanagh
Lindsay E. Calderon
- BioMed Central
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