“Universal Decolonization” of ICU Patients Reduces Bloodstream Infections by 44 percent
NASHVILLE, Tenn.--(BUSINESS WIRE)--HCA (NYSE: HCA), one of the nation’s leading providers of healthcare services, today announced a comprehensive infection prevention study, conducted exclusively at 43 HCA-affiliated hospitals, has been published in the New England Journal of Medicine.
The study, known as Randomized Evaluation of Decolonization Versus Universal Clearance to Eliminate (REDUCE) MRSA, was conducted in conjunction with investigators at Harvard and several other academic institutions, and research programs at two U.S. Department of Health and Human Services agencies, the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Disease Control and Prevention (CDC). The use of antimicrobial agents on an entire patient population is referred to as universal decolonization. The study found that using antimicrobial soap and ointment to decolonize all intensive care unit patients reduces all bloodstream infections, including MRSA by 44 percent.
The findings suggest a major change in healthcare practice that could save lives. As a result of the findings, HCA is in the process of implementing universal decolonization in its adult intensive care units at its affiliated hospitals.
“The REDUCE MRSA study proved that universal decolonization is the best practice to prevent infection from MRSA and other dangerous bacteria in high risk ICU patients,” said Jonathan B. Perlin, MD, President, Clinical and Physician Services Group and Chief Medical Officer of HCA. “These compelling results convinced us to implement this protocol in HCA hospital adult ICUs. Universal decolonization should be a new part of a comprehensive infection prevention effort that begins with hand hygiene and includes a number of proven practices.”
The study, which involved nearly 75,000 patients and more than 280,000 patient days in 74 adult ICUs located in 16 states, compared the results of three approaches in ICUs:
- Screen all patients and isolate MRSA carriers
- Targeted decolonization: screening, isolation, and decolonization of MRSA carriers with chlorhexidine and mupirocin ointment
- Universal decolonization: no screening and all patients decolonized with chlorhexidine and nasal mupirocin ointment.
The REDUCE MRSA team found that using universal decolonization reduced MRSA clinical cultures by 37 percent. Patients colonized with MRSA may not be sick, but they are at risk for later illness and for spreading it to others. All bloodstream infections were decreased by 44 percent. The researchers noted that this trial took place in HCA facilities, mostly in community hospitals, rather than academic institutions and was conducted by hospital personnel rather than specially trained research staff. Therefore, unlike some clinical studies, these results are likely to be applicable to nearly all U.S. hospitals.
REDUCE MRSA was a collaborative effort. The study concept and design was created by investigators in the CDC’s Prevention Epicenter Program at the University of California, Irvine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Rush University and Washington University in St. Louis. AHRQ’s Healthcare Associated Infections program provided funding, and the research was conducted through AHRQ’s Developing Evidence to Inform Decisions about Effectiveness (DECIDE) network.
“This unprecedented partnership has yielded information that not only makes preventing MRSA and other serious infections simpler and more effective, it sets a new standard for responsible infection prevention,” said Perlin.
All references to “Company” and “HCA” as used through this release refer to HCA Holdings, Inc. and its affiliates.
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