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IDSA: Universal Decolonization Cuts Infection Risk in ICU

Last Updated: October 18, 2012.

For patients in the intensive care unit, universal decolonization, including daily chlorhexidine baths and mupirocin for five days, is associated with a significant reduction in the risk of methicillin-resistant Staphylococcus aureus clinical cultures and bloodstream infections of all pathogens, according to a study presented at the annual meeting of the Infectious Diseases Society of America (IDWeek), held from Oct. 17 to 21 in San Diego.

THURSDAY, Oct. 18 (HealthDay News) -- For patients in the intensive care unit (ICU), universal decolonization, including daily chlorhexidine baths and mupirocin for five days, is associated with a significant reduction in the risk of methicillin-resistant Staphylococcus aureus (MRSA) clinical cultures and bloodstream infections of all pathogens, according to a study presented at the annual meeting of the Infectious Diseases Society of America (IDWeek), held from Oct. 17 to 21 in San Diego.

Susan Huang, M.D., M.P.H., from the University of California Irvine School of Medicine in Orange, and colleagues conducted a three-arm cluster randomized trial of MRSA prevention strategies. Forty-three hospitals, including 74 adult ICUs in 16 states, were randomized to screening and isolation; targeted decolonization; and universal decolonization. The study design comprised a one-year baseline period (48,390 admissions) and an 18-month intervention period (74,256 admissions).

The researchers found that, compared with screening and isolation, universal decolonization correlated with a significantly greater reduction in the hazard of MRSA clinical cultures (unadjusted hazard ratio [HR], 0.63; adjusted HR, 0.69) and bloodstream infections (all pathogens; unadjusted and adjusted HR, 0.56). The results for targeted decolonization were comparable to those for screening and isolation.

"A 44 percent reduction in infection is very promising for improving medical care and protecting highly vulnerable patients," Huang said in a statement. "It suggests that treating all ICU patients with this strategy is beneficial. This approach may make screening for drug-resistant organisms unnecessary."

Several authors disclosed financial ties to the medical product and pharmaceutical industries.

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