Updated Infection Prevention Recommendations Focus on Sanitation

The Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission released updated recommendations for the prevention of methicillin-resistant Staphylococcus aureus (MRSA) transmission and infection.

Infections caused by MRSA increased by as much as 41% during the pandemic. According to SHEA, MRSA causes roughly 10% of hospital-associated infections (HAIs) in the U.S. These infections are associated with an increased risk of death.

“Strategies to Prevent Methicillin-Resistant Staphylococcus aureus Transmission and Infection in Acute Care Hospitals” provides recommendations to prevent the spread of MRSA and reduce the risk of MRSA infection. The document published last week in the journal “Infection Control & Hospital Epidemiology,” (ICHE) is the most recently updated guidance in the series known collectively as the Compendium.  

MRSA infection is caused by a type of staph bacteria that is resistant to many of the antibiotics used to treat ordinary staph infections. Healthcare-associated MRSA infections often follow invasive procedures, such as surgeries, or the use of devices, such as central venous catheters, and can be spread within hospitals by the hands of healthcare personnel or through contact with contaminated surfaces and equipment.

The new recommendations describe basic infection prevention practices, such as proper hand hygiene, cleaning of the healthcare environment, and the disinfection of equipment. Further, it provides guidance to help hospitals assess risk, make informed decisions, monitor outcomes associated with changes in the use of contact precautions, and identify populations and scenarios in which continued use of contact precautions should be considered.

The updated recommendations also changed the guidance of how antibiotics are prescribed and used from an “additional practice” to an “essential practice,” meaning all hospitals should follow it. When someone with MRSA receives treatment with antibiotics for another infection, they may have a higher risk of developing MRSA infection and may be more likely to transmit MRSA to others. Avoiding unnecessary use of antibiotics may decrease these and other risks associated with antibiotic use.

The updated recommendations replaced SHEA’s Compendium published in 2008 and updated in 2014. In the coming weeks, a new Compendium section will be published outlining approaches to the implementation of infection prevention strategies.

Recently published Compendium updates also include strategies for preventing surgical site infections, central line-associated bloodstream infections, ventilator and non-ventilator associated pneumonia, and strategies to prevent HAIs through hand hygiene.

“The enormous strain put on healthcare during the pandemic may have contributed to the observed increase in some hospital infections. We have data that show MRSA infections rose,” said David Calfee, senior author of the updated guidance and editor of ICHE. “The evidence that informs these recommendations shows that we can be successful in preventing transmission and infection. We can get back to the pre-2020 rates and then do even better.”