VANCOUVER, B.C. — The most effective strategy for preventing colonizations and infections with methicillin-resistant Staphylococcus aureus in ICUs is a combination of universal contact precautions and universal decolonization, according to a computer simulation analysis.
Among a hypothetical cohort of 100,000 adult patients admitted to ICUs, such a combination strategy would prevent an estimated 54% of colonizations and 51% of MRSA infections compared with standard precautions, Dr. Courtney A. Gidengil said at the meeting.
Standard precautions include careful hand washing by health care workers and appropriate cleaning of the hospital environment. Universal contact precautions involve isolating affected patients in a private room or in a room with other MRSA patients. All health care workers must don gloves and gowns before seeing the patient. Universal decolonization involves daily chlorhexidine gluconate (CHG) baths along with twice-daily applications of mupirocin nasal ointment, both for 5 days.
The next most effective strategy, according to the analysis, would be a combination of universal contact precautions and universal CHG baths, which would prevent about 38% of colonizations and 40% of infections, said Dr. Gidengil of Children's Hospital Boston and the Rand Corp.
Universal decolonization alone would prevent 34% of colonizations and 40% of infections. Universal contact precautions alone would prevent 29% of colonizations and 26% of infections. And universal CHG baths alone would prevent 12% of colonizations and 23% of infections.
Dr Gidengil and her coinvestigators reported having no conflicts of interest. The Centers for Disease Control and Prevention and the National Institute of General Medical Sciences funded the study.