MRSA rates have decreased by more than 20 percent in most areas of the Tower in the last year, thanks to the collaboration of Infection Control practitioners and staff throughout the hospital.
“This drop in MRSA rates is because of the hard work of staff in many areas,” said Deborah Yokoe, MD, of Infectious Disease. “We count on the collaboration of all BWHers to continue protecting our patients and staff from infection.”
MRSA, or methicillin-resistant staphylococcus aureus, is a type of bacteria resistant to treatment with usual antibiotics that can cause life-threatening infections, such as pneumonia, surgical site infection and bloodstream infection. MRSA occurs most frequently among patients who undergo invasive medical procedures or who have weakened immune systems.
With a goal of reducing MRSA rates by 20 percent, BWH Infection Control and other departments initiated several efforts. Environmental Services led an effort to improve cleaning of patient rooms upon discharge after Susan Huang, MD, MPH, of BWH Infection Control, published a study in the Archives of Internal Medicine demonstrating that a patient is at greater risk to acquire MRSA when admitted to a room where the previous patient had MRSA.
Another study involved applying invisible gel to high-touch surfaces before cleaning, then shining a black light on them post-cleaning to confirm that cleaning was thorough. This process of auditing actual cleaning effectiveness is now a standard Environmental Services procedure in ICUs.
“If the surface isn’t cleaned sufficiently, you can still see the gel under the black light,” said Director of Environmental Services Rick Bass.
Certain areas, including doorknobs and toilet handles, needed more attention. “We re-educated staff focusing on these high-touch areas,” he said. This training, combined with a change in cleaning procedure where staff dip a rag into a bucket of cleaning solution rather than spray a rag with solution, have contributed to decreased MRSA rates.
Another effort involves active surveillance cultures in the highest risk population—the intensive care units, Bone Marrow Transplant and Oncology—where patients are cultured weekly for MRSA upon admission. “We identify patients with MRSA as early as possible during their hospital stay so that we can prevent it from spreading,” Susan Marino, MS, CIC, infection control practitioner, said.
Those units are targeted because their patients are at high risk, but rates of MRSA have dropped on many step-down units as well. “What helps the ICUs helps the rest of the hospital because patients are transferred between units so frequently,” Yokoe explained.