Interesting nursing home study on MRSA

[Michael Wishart]

This recently published study on nursing home MRSA in Switzerland demonstrated a screening and decolonisation programme had no effect on MRSA carriage rates.

http://journals.cambridge.org/action/displayAbstract?fromPageonline&aid9611081&fulltextTypeRA&fileIdS0899823X14000749

Great to see such a negative study published from the non-acute sector.

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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[Verily Thomas]

It is interesting indeed that even though this being said the majority of patients presenting to acute care facilities and now an even greater burden on healthcare than healthcare associated staphylococcus aureus (MRSA & MSSA) blood stream infections seem to come from the community with a significant number of these coming from long term care residential facilities.

Makes me wonder whether these infections are being costed to, LTCRF or to acute care facilities, just saying.Isnt this the whole idea of decolonisation to9 prevent simple colonisations turning into life threatening and debilitating infections?

Kind Regards

Verily Thomas
Clinical Nurse Consultant | Infection Prevention and Control
SWSLHD-Bankstown/Lidcombe Hospital
Eldridge Road, Bansktown.NSW 2200
Tel 02 97228000 pager 28230
Tel 02 9722 8633 | Fax 02 9722 7822 | verily.thomas@sswahs.nsw.gov.au
http://www.health.nsw.gov.au

[Description: cid:image002.jpg@01CE8EA5.483A6E60]
LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVES

This recently published study on nursing home MRSA in Switzerland demonstrated a screening and decolonisation programme had no effect on MRSA carriage rates.

http://journals.cambridge.org/action/displayAbstract?fromPageonline&aid9611081&fulltextTypeRA&fileIdS0899823X14000749

Great to see such a negative study published from the non-acute sector.

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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[Michael Wishart]

Hi Verily

Yes, it is vexing that the majority of infection risk is within acute care. My understanding of previous studies seems to indicate that decolonisation as a strategy is useful to minimise short term risk (ie decolonisation prior to a major procedure), but is not as useful as a long term carrier-eradication strategy. This study would support that idea.

This may suggest that acute care facilities need to continue look at checking carrier status and then providing appropriate decolonisation/antibiotic prophylaxis regimes prior to high risk procedures, rather than depend upon residential care decolonisation strategies.

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0]
P Please consider the environment before printing this email

It is interesting indeed that even though this being said the majority of patients presenting to acute care facilities and now an even greater burden on healthcare than healthcare associated staphylococcus aureus (MRSA & MSSA) blood stream infections seem to come from the community with a significant number of these coming from long term care residential facilities.

Makes me wonder whether these infections are being costed to, LTCRF or to acute care facilities, just saying.Isnt this the whole idea of decolonisation to9 prevent simple colonisations turning into life threatening and debilitating infections?

Kind Regards

Verily Thomas
Clinical Nurse Consultant | Infection Prevention and Control
SWSLHD-Bankstown/Lidcombe Hospital
Eldridge Road, Bansktown.NSW 2200
Tel 02 97228000 pager 28230
Tel 02 9722 8633 | Fax 02 9722 7822 | verily.thomas@sswahs.nsw.gov.au
http://www.health.nsw.gov.au

[Description: cid:image002.jpg@01CE8EA5.483A6E60]
LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVES

This recently published study on nursing home MRSA in Switzerland demonstrated a screening and decolonisation programme had no effect on MRSA carriage rates.

http://journals.cambridge.org/action/displayAbstract?fromPageonline&aid9611081&fulltextTypeRA&fileIdS0899823X14000749

Great to see such a negative study published from the non-acute sector.

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0]
P Please consider the environment before printing this email

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[Marija Juraja]

Dear colleagues,

Heartily agree with your views.
It’s a discussion we have been having for a significant time within our own unit, especially with the alarming numbers of other MROs coming in such as ESBLs and AMPC etc. Its endemic in the community and over concern is CRE and do we really want that endemic!
I agree it is their home but wouldn’t most people be keeping their home clean and tidy, washing their hands and using products that remove bio-burden. I know cost seems to be the biggest push in these facilities as well as the over usage of antibiotics for asymptomatic UTIs.
I agree everyday practice of standard precautions improves the care and has potential to reduce poor outcomes.
AMS in RACF is another issue that is another beast that needs to be addressed and I think things have already started in that arena through NAPS.

Again just my personal views.

Kind Regards

Marija Juraja |Clinical Service Coordinator (RN, GCNS Inf Ctrl, CICP)
Infection Prevention & Control Unit| Division of Acute Medicine
t: +61 8 8222 7588| p: 47757|

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Dear colleagues,
I find this whole debate on decolonisation strategies interesting. I agree with Michael that the literature seems to support a role for decolonisation of carriers prior to high risk procedures, but is not necessarily effective as a strategy for overall decrease of carriage rate. I did note that the intervention group showed a slightly greater decrease in carriage rate compared to the control group, although this was not statistically significant.

The interesting thing I thought about this study is that in both groups of nursing homes the colonisation rate decreased significantly, which I would suggest was due to better reinforcement of standard precautions. The overall adherence to standard precautions in nursing homes is generally rather poor. The usual excuse I have heard: “this is the resident’s home, and we don’t want to alarm them by wearing PPE, etc.” doesn’t wash with me. I believe residents would be relieved to know that the standard of infection control in their home was of the highest order. I think it is a matter of proper risk communication.

My thought for the day!
Irene

Irene Wilkinson
Manager, Infection Control Service
Communicable Disease Control Branch
SA Department of Health
PO Box 6 Rundle Mall, Adelaide SA 5000

http://www.sahealth.sa.gov.au/infectionprevention
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Hi Verily

Yes, it is vexing that the majority of infection risk is within acute care. My understanding of previous studies seems to indicate that decolonisation as a strategy is useful to minimise short term risk (ie decolonisation prior to a major procedure), but is not as useful as a long term carrier-eradication strategy. This study would support that idea.

This may suggest that acute care facilities need to continue look at checking carrier status and then providing appropriate decolonisation/antibiotic prophylaxis regimes prior to high risk procedures, rather than depend upon residential care decolonisation strategies.

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.gif@01D07372.4409E6F0]
P Please consider the environment before printing this email

It is interesting indeed that even though this being said the majority of patients presenting to acute care facilities and now an even greater burden on healthcare than healthcare associated staphylococcus aureus (MRSA & MSSA) blood stream infections seem to come from the community with a significant number of these coming from long term care residential facilities.

Makes me wonder whether these infections are being costed to, LTCRF or to acute care facilities, just saying.Isnt this the whole idea of decolonisation to9 prevent simple colonisations turning into life threatening and debilitating infections?

Kind Regards

Verily Thomas
Clinical Nurse Consultant | Infection Prevention and Control
SWSLHD-Bankstown/Lidcombe Hospital
Eldridge Road, Bansktown.NSW 2200
Tel 02 97228000 pager 28230
Tel 02 9722 8633 | Fax 02 9722 7822 | verily.thomas@sswahs.nsw.gov.au
http://www.health.nsw.gov.au

[cid:image001.jpg@01D0736C.5A999060]
LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVES

This recently published study on nursing home MRSA in Switzerland demonstrated a screening and decolonisation programme had no effect on MRSA carriage rates.

http://journals.cambridge.org/action/displayAbstract?fromPageonline&aid9611081&fulltextTypeRA&fileIdS0899823X14000749

Great to see such a negative study published from the non-acute sector.

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.gif@01D072E1.1F1E1E60]
P Please consider the environment before printing this email

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