Lab ID MRSA surveillance infections remain a vexing problem. The majority of these infections are from a patient's own endogenous flora. How can we best tackle this issue?
All infection prevention starts with the robust horizontal infection control strategy. Hand hygiene is also critically important. At my institution we are now starting the deployment of 5000 hand hygiene sensor badges for inpatient care, to increase reliability with foam in/foam out hand hygiene practice.
The extent to which contact precautions prevents endemic MRSA transmission remains highly debatable, as explored here. Contact precautions may not be the way to go to reduce Lab ID MRSA infections.
Universal staphylococcal decolonization (intranasal mupirocin+CHG bathing) in ICU settings reduces clinical isolates and bloodstream infections from all pathogens, as reported here. The same is not true (no clinical benefit) in non ICU settings as recently published in Lancet.
To reduce Lab ID MRSA infections and other hospital-acquired infections it is now time to seriously consider universal decolonization in ICU populations as part of a robust horizontal infection control program.
