More careful attention to cleanliness in hospitals can help curb infections caused by antibiotic-resistant bacteria. But even stringent hygiene only goes so far in beating the germs back.
Antibiotic-resistant staph infections can be deadly for hospital patients.
One way to curb them is with better hospital hygiene. A new study found that hand-washing, and wearing gowns and gloves, cuts the number of infections with methicilln-resistant Staphylococcus aureus, or MRSA. But another study found that even with all those precautions, the bacteria can still be tough to wipe out.
In 2007, the VA hospital system launched a huge effort to reduce the number of MRSA infections by ordering all 150 of its acute-care hospitals to change how they do business. For starters, patients were screened for MRSA when they were admitted. And about 14 percent of them turned out to carry MRSA in their noses, even though they weren't sick.
Hospital employees were told to wear gloves and gowns when treating those carriers, and to be sure to wash hands before and after treating patients. That lowered MRSA infections of patients in intensive care units by 62 percent over three years.
But when a second group of researchers used similar tactics to try to stop the spread of MRSA in 18 academic medical centers, it didn't stop the bacteria from traveling from patient to patient. "We looked at whether the health care workers wore clean gloves and did hand hygiene," says W. Charles Huskins, an infectious disease specialist at the Mayo Clinic and lead author of the second study. "We didn't find a correlation between those behaviors and the outcomes. You would expect units with lower adherence to have worse outcomes, and we didn't."
Huskins tells Shots that workers were less careful about hand-washing and proper use of gloves and gowns when they were just touching objects in a patient's room. So it may be that hospitals will need to come up with better ways to clean hospital rooms to keep the bug at bay. Or, Huskins told Shots, it may take another intervention, like swabbing patients with antimicrobial rinses, to stop MRSA.
Both studies appeared in the latest issue of the New England Journal of Medicine.
The number of MRSA infections has been dropping overall, down 28 percent in 9 cities over four years, according to a study published last year in the Journal of the American Medical Association. So it could be that we're getting better at battling MRSA. But as that second study shows, the bug has hardly called it quits.
Separately, earlier this week the Department of Health and Human Services pledged up to $1 billion toward improvements in quality of hospital care. Reducing hosptial infections is one of the top priorities.
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