MRSA incidence in dialysis patients declining

[okarol]

MRSA incidence in dialysis patients declining
Nguyen D. Clin Infect Dis. 2013;doi:10.1093/cid/cit546.

September 9, 2013
There has been a significant decrease in the incidence of invasive methicillin-resistant Staphylococcus aureus among patients receiving dialysis, researchers reported in Clinical Infectious Diseases.

“Factors contributing to this decrease may include better MRSA and bloodstream infection prevention in hospitals, and efforts to decrease central venous catheter use in outpatient dialysis facilities,” Duc B. Nguyen, MD, of the CDC’s Division of Healthcare Quality Promotion, told Infectious Disease News. “However, the burden is still high and more needs to be done to further reduce infections in this vulnerable population.”

Nguyen and colleagues evaluated data from the CDC’s Active Bacterial Core surveillance system for invasive MRSA infections. The study included patients on dialysis who developed invasive MRSA from 2005 to 2011, and investigators analyzed the change in incidence during that time.

There were 7,489 cases identified: 85.7% were health care-associated community onset, and 93.2% were bloodstream infections. After controlling for age, sex and race, the incidence of invasive MRSA infection decreased 7.3% per year, for an overall decrease of 51.1% during the 7-year period.

From 2009 to 2011, there were 2,642 patients with available data on vascular access. Most of the invasive MRSA infections (60.4%) occurred in patients who had a central venous catheter. Among these cases, 70% had been hospitalized within a year before infection.

“Health care personnel should follow recommended practices to prevent bloodstream infections, which should include adherence to standard precautions,” Nguyen said. “CDC has created a number of checklists, educational resources and other tools, specifically, to help outpatient dialysis staff improve catheter care and routinely engage in other evidence-based practices that can prevent infections.”

Nguyen said when more data are available, it will be possible to evaluate the rates of invasive MRSA infections among patients with different vascular access types. He also is interested in reviewing infection prevention practices at dialysis facilities over time to assess the extent to which changes in these practices might contribute to trends in MRSA incidence.

Duc Nguyen, MD, can be reached at 1600 Clifton Road NE, MS-A35, Atlanta, GA 30333; email: vif8@cdc.gov.

Disclosure: Nguyen reports no relevant financial disclosures.

http://www.healio.com/infectious-disease/mrsa/news/online/%7B9019ca48-85ec-4c4b-a347-30183db53f7d%7D/mrsa-incidence-in-dialysis-patients-declining

[Tío Riñon]

Glad to hear that they are starting to get a handle on this.  When I was hospitalized in the Netherlands a few years ago, I was quarantined while they determined whether I had MRSA or not.  Everyone from food service to doctors had to change into full body suits before they came into my room.  Definitely a challenge to communicate with medical staff when you don't know the language AND be considered a potential danger. 

Hope they solve this so no one else has to go through a similar experience.

[rocker]

You think it could have anything to do with Medicare now not paying for readmissions due to hospital-acquired infections?

Naaaaaaah, sure it's just a coincidence.