VHA program reduces MRSA infections by nearly 90% in veterans living center

A decolonization effort spearheaded by the Veterans Health Administration reduced the rate of methicillin-resistant Staphylococcus aureus infections among residents at Salisbury (N.C.) VeteransAffairsCommunityLivingCenter by 89 percent over a four-year span, according to a study presented the 44th Annual Conference of the Association for Professionals in Infection Control and Epidemiology in Portland, Ore.

The VHA began testing all documented MRSA-negative residents for colonization in 2012 and launched the decolonization initiative in 2013. Residents who tested positive for MRSA received daily chlorhexidine baths and were treated with intra-nasal mupirocin. Additionally, environmental service workers cleaned all common areas, bathrooms and resident rooms. Environmental cleaning also included the use of ultraviolet light sterilization products. The change in decolonization policy also resulted in a reduced need for the use of personal protective equipment by staff.

From the first quarter of 2013 to the fourth quarter of 2013, the prevalence of MRSA among the residents dropped from 45 percent to 16 percent. By the end of 2016, the rate of MRSA infections decreased by 89 percent. Researchers estimated the initiative resulted in 64 fewer infections over the four years, saving approximately $2.2 million in treatment costs.

"The cornerstone of this program was strict environmental control, decontamination and cleaning," said lead study author Lanette Hughes, BSN, RN, infection preventionist at the Salisbury VA Community Living Center. "In addition to the substantial monetary savings from using less personal protective equipment, this initiative also fostered a better environment for residents and staff, improving the overall workflow of the living centers."

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