Postdischarge Decolonization Plan Lowers MRSA Risk

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The at-home protocol involved chlorhexidine mouthwash, chlorhexidine baths or showers, and nasal mupirocin.

MRSA infections are highly prevalent in health and community settings, and are associated with significant morbidity and mortality. In addition, death occurs in about 5% of MRSA-positive cases, and ip to 6% of people in the U.S. are also asymptomatically colonized with MRSA.

A 2014 report in The Hospitalist stated that MRSA was the most common pathogen in surgical site infections (SSIs) and ventilator-associated pneumonias. More than 80,000 invasive infections per year in the U.S. are attributable to MRSA, and MRSA infections are estimated to cost U.S. hospitals $3.2 billion to $4.2 billion per year. Approximately 25% of individuals who are colonized with MRSA for more than 1 year will develop a late-onset MRSA infection.

Rates of invasive MRSA infections are highest within 6 months after hospital discharge and do not normalize for a year, noted Susan Huang, MD, of the University of California Irvine School of Medicine, and colleagues, in the New England Journal of Medicine.

Earlier studies from Huang’s group and others confirmed that an aggressive decolonization within the ICU setting reduced the risk of surgical-site infections, and decolonization protocols are now standard in ICU care.

“The success in the ICU led us to ask the question, ‘Where else can decolonization reduce infection risk?'” Huang said.



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