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New CLSI Report Provides Guidance on MRSA Surveillance

Published March 7, 2010 4:28 PM by Glen McDaniel

As infections due to methicillin-resistant Staphylococcus aureus  (MRSA) has climbed dramatically, so has the concern about the resultant morbidity and mortality in healthcare settings as well as in the community. Whether nosocomial or community acquired, MRSA is of concern to government agencies, healthcare providers and the public at large.

One strategy to reduce transmission in healthcare settings is to conduct active surveillance of patients admitted to healthcare settings for colonization and then placing such patients in contact isolation-with or without the adjunct of aggressive antimicrobial intervention.

Colonized patients are potential reservoirs of infection for themselves, other patients and healthcare workers, who might then further infect additional patients. What subset of patients should be tested? How wide should  the surveillance net be cast? What measures should be taken with patients who are colonized? All these factors should be considered as part of any organizational surveillance program. A brand new CLSI report, titled Surveillance for Methicillin-Resistant Staphylococcus aureus: Principles, Practices, and Challenges; A Report (X07-R)  addresses these questions and more.

Has your institution adopted MRSA surveillance?  What's the process? 

 

posted by Glen McDaniel

3 comments

Stephanie:

It's not surprising that attorneys have caught on to the fact that CMS/Medicare has identified certain events including nosocomial infections as events that should never happen in a hospital. That  is, some events should never be caused by the action or negligence of healthcare workers. Such "never events" add considerably to the length of stay, cost of patient care and sometimes may even result in death.

I blogged about these about a year ago.

http://community.advanceweb.com/blogs/mt_2/archive/2009/02/13/ceo-issues-infection-challenge.aspx

Recently a study was published in the Archives of Internal Medicine indicating that healthcare-associated pneumonia affects 250,000 patients annually while 750,000 patients become septic in hospitals annually.This adds an estimated $8.1 billion to the cost of care. Worse than that, 48,000 patients actually die each year from just these 2 classes of infections alone.

http://www.fiercehealthcare.com/story/preventable-hospital-acquired-infections-kill-48-000-annually/2010-02-23

Attorneys realize that If patients/families can prove that an infection like C. diff was nosocomial in origin, that can be converted to dollars!  The American legal system is nothing if not entrepreneurial.

Many hospitals have started defensive documentation: over documenting to show that an infection or other condition discovered during a hospital stay was not caused from the stay and might even have been present before admission. Anything (whether infection, complication or adverse outcome) that happens in a healthcare setting is immediately suspect, scrutinized-and may not be reimbursed.

MRSA is high on the list of such "suspects."

Glen McDaniel March 14, 2010 3:08 PM

I recently saw a commercial for a law firm that seems to specialize in medical malpractice.  It included a long list in tiny print of "never events" in health care facilities.  My question is whether the Center for Medicare and Medicaid services actually considers Clostridium difficile infection a "never event." (I'm very curious about this since "C-diff" was at the bottom of their miniscule list.)

Stephanie Mathis, MLS(ASCP), Generalist - Medical Laboratory Scientist, Bluefield Regional Medical Center March 11, 2010 7:13 PM
Bluefield WV

My infection control nurse wants to do environmental cultures. But she wants to swab surfaces in ED and ICU. I am not sure how wise this is, but even as a non-microbiologist it seems to me that would be overkill. Arent we supposed to be doing best practices and spending money where we get the best return? Any ideas from my micro fellow CLS?

Roberto CLS (NCA) March 11, 2010 11:56 AM
Atlanta GA

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