Take stronger steps to prevent staph infections and sepsis



Serious infections from Staphylococcus aureus caused nearly 20,000 deaths and 119,000 illnesses in the United States in 2017, according to data from a Vital Signs report issued by the Centers for Disease Control and Prevention. The data include both methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA).

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Although MRSA infections in health care settings declined by approximately 17% during 2005-2012, rates plateaued during 2012-2017, Anne Schuchat, MD, principal deputy director of the CDC, said in a teleconference March 5 to present the findings. The report emphasizes the potential for serious illness and death with any staph infection and the need for ongoing vigilance on the part of clinicians, she said.

In addition, community-onset MSSA infections increased by 3.9%/year during 2012-2017. Data from previous studies suggest that this increase may be connected to the opioid epidemic, said Dr. Schuchat.

“People who inject drugs are 16% more likely to develop a staph infection” than are those who don’t inject drugs, she said.

Community-onset MRSA declined by 6.9% during 2001-2016, attributed to declines in health care–associated infections, according to Vital Signs author Athena P. Kourtis, MD, of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, and her colleagues. Rates of hospital-associated MSSA infection remained essentially unchanged (P = .11). The overall unadjusted in-hospital mortality among patients with S. aureus bloodstream infections over the study period was 18%.

The data for the report were collected from electronic health records at more than 400 acute care hospitals, as well as population-based surveillance data from the CDC’s Emerging Infections Program.

Most people carry staph on their skin with no ill effects, but the bacteria become dangerous when they enter the bloodstream, Dr. Schuchat emphasized. “We hope the new data today will refocus the nation’s efforts to protect patients from staph infections,” she said.

Dr. Schuchat advised clinicians and hospital administrators to review their data and step up their safety protocols to prevent staph infections. Precautions include wearing gowns and gloves, following proper hand washing protocols, cautious use of antibiotics, and treating infections rapidly when they occur, she said. Dr. Schuchat noted that lack of adherence to these recommendations may have declined in recent years if clinicians and hospital administrators were wondering whether their protocols have an effect and have value. However, “this is a very serious infection, and we think it is very much worth preventing,” she emphasized.

Other strategies to prevent staph infections in health care settings include reviewing infection data regularly, exploring new approaches to prevent infections, and educating patients about when they may be at increased risk for infection, such as when invasive devices are in place or during surgical procedures. Also, clinicians should be aware of the increased risk for patients who inject drugs, Dr. Schuchat said.

Dr. Schuchat commended the Department of Veterans Affairs Medical Centers (VAMC), which overall reduced their rate of staph infections by 43% during the period from 2005 through 2017 in contrast to the national trend. These findings also appeared in the MMWR on March 5. The VAMC implemented additional interventions and increased their adherence to CDC recommendations during this period, she noted.

The Vital Signs data were published March 5 in the CDC’s Morbidity and Mortality Weekly Report; read the full report here.

The CDC researchers had no financial conflicts to disclose.

SOURCE: Kourtis AP et al. MMWR. 2019 Mar 5; 68:1-6.

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