March 13th, 2019. Methicillin-resistant Staphylococcus aureus (MRSA) infections and hospitalizations after hospital discharge were reduced by 30 percent in patients known to carry the bacteria on their body by a treatment that cleansed the bacteria from their skin or in their noses, according to new research funded by the The Agency for Healthcare Research and Quality (AHRQ) (A body under U.S. Department of Health & Human Services). Patients were treated with a combination of an over-the-counter antiseptic for bathing or showering, plus prescription antiseptic mouthwash and antibiotic nasal ointment.
MRSA causes more than 80,000 invasive infections each year in the U.S.
The study in the February 14 issue of the New England Journal of Medicine included more than 2,000 patients with MRSA who were discharged from Southern California hospitals between 2011 and 2014. Patients in one group received an educational binder with recommendations for preventing infections via personal hygiene, laundry, and household cleaning. A second group received the same educational materials, but for 6 months also took steps to remove MRSA from their skin and noses with chlorhexidine antiseptic for bathing, chlorhexidine mouthwash, and the nasal antibiotic ointment mupirocin.
In the overall treatment group, the 30 percent reduction in MRSA infections was accompanied by a 17 percent reduction in all infections, according to the study results. Of note, participants who followed the treatment completely had a 44 percent reduction in MRSA infections and a 40 percent reduction in all infections.
“It is estimated that MRSA causes more than 80,000 invasive infections each year in the U.S.,” said AHRQ Director Gopal Khanna, M.B.A. “The results of this study show that focused attention on removing MRSA can reduce infections and make a measurable difference in the lives of patients. We’re pleased that this work adds significantly to the Agency’s track record of supporting vital research to improve the safety of healthcare in this Nation.”
Side effects of the decolonization treatment
Side effects were minimal among patients who used the decolonization treatment. About 2 percent of patients reported mild side effects to the antiseptic for bathing, while 1 percent reported mild side effects to the mouthwash or nasal ointment. About 40 percent of those who experienced side effects from a product opted to continue their use.
“Protecting the health of patients after discharge is an important part of care,” said Susan Huang, M.D., M.P.H., Professor of Medicine in the Division of Infectious Diseases and Medical Director, Epidemiology and Infection Prevention, at the University of California Irvine, School of Medicine. “But not enough is known about how to help patients avoid infections, including those patients who harbor highly antibiotic-resistant pathogens. This study represents an important step toward keeping patients safe.”
The study, known as the Project CLEAR (Changing Lives by Eradicating Antibiotic Resistance) Trial, was conducted through longstanding collaborations between the University of California Irvine, Los Angeles Biomedical Research Institute at Harbor-UCLA, and Rush University. In addition to AHRQ funding, the study was also supported by the University of California Irvine Institute for Clinical and Translational Science, which was funded by a grant from the National Institutes of Health Clinical and Translational Sciences Award Program.
Project CLEAR is a prime example of AHRQ’s efforts to generate evidence and tools to help the healthcare system improve patient safety.