Staphylococcus aureus, a prevalent pathogen in healthcare-associated infections (HAI), poses a significant challenge due to its antibiotic-resistant strain, Methicillin-resistant Staphylococcus aureus (MRSA). The impact of MRSA cannot be understated, with a substantial portion of ICU infections worldwide being attributed to it. Despite notable efforts to combat its spread, MRSA remains a common issue in healthcare settings. In response to the persistent threat, several notable infection control professional organizations have joined forces to update the guidance document for acute-care hospitals to prevent MRSA transmission. Emphasizing a multi-pronged approach, the 2022 MRSA prevention update highlights evidence-based practices to strengthen infection prevention programs.
Staphylococcus aureus is one of the most common pathogens seen in healthcare-associated infections (HAI). Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that is resistant to several antibiotics, making it much harder to treat. It is estimated that 15% of ICU infections are caused by S. aureus worldwide, and 31% of those are due to MRSA. In North America, S. aureus causes about 23% of ICU infections, and 44% of those are due to MRSA. Staphylococcus aureus is one of the most common pathogens causing HAIs in the US. In 2011, 80,461 MRSA Infections were reported, with an in-hospital mortality rate of 14%. With over 11,000 deaths in 2011 and 10,000 deaths in 2017 in the US alone, MRSA poses a significant challenge for healthcare institutions.
In 2022, the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Association for Professionals in Infection Control and Epidemiology (APIC) came together to update the guidance document of recommendations for acute-care hospitals to prevent MRSA transmission. These guidelines have not been updated since 2014, nearly a decade ago. The rate of hospital-onset MRSA bloodstream infections decreased by 17% every year from 2012 to 2017, but increased by 15% from 2019 to 2020 with the onset of the COVID-19 pandemic. When comparing the first quarters of 2019 and 2020, HAI rates actually decreased by 7.2%. However, HAI rates increased for the rest of the year as the pandemic progressed. This emphasizes the importance of implementing and adhering to preventive measures, so SHEA, IDSA, and APIC recommend a multi-pronged approach within their update on the guidance to prevent MRSA transmission.
The 2022 MRSA prevention update listed eleven essential practices, with the following three having a higher quality of evidence than the other eight.
Promote compliance with CDC or WHO hand hygiene recommendations. MRSA is commonly spread to patients by contaminated hands of healthcare providers. Proper hand hygiene prevents the transmission of many different pathogens.
Use contact precautions for MRSA-colonized and MRSA-infected patients. Surfaces, objects, and healthcare providers can easily become contaminated in rooms with MRSA patients. Contact precautions are essential for limiting MRSA transmission. Patients with known MRSA colonization or infection require appropriate precautions to reduce the risk of spreading the organism to healthcare personnel, other patients, and the surrounding environment.
Ensure cleaning and disinfection of equipment and the environment. Overbed tables, bed rails, furniture, sinks, floors, stethoscopes, blood pressure cuffs, and everything else in a patient room needs to be disinfected thoroughly. Cleaning AND disinfecting, as separate practices, are essential for reducing the transmission of pathogens. Additionally, monitoring of cleaning and disinfection procedures has shown to improve thoroughness of environmental services (EVS) personnel.
Consistent environmental cleaning and disinfection are important components of hospital infection prevention programs. Even with established manual cleaning protocols, hospitals may evaluate supplemental technologies to address environmental contamination and support standardized disinfection workflows.
Breezy Blue® is an automated whole-room disinfection system that uses aerosolized hydrogen peroxide. It is designed to supplement, not replace, routine manual cleaning and disinfection.
Laboratory testing has evaluated Breezy's effectiveness against MRSA under defined treatment conditions. Results should be interpreted according to the tested organism, treatment protocol and applicable product labeling.
Breezy Blue also connects with Breezy Cloud™, which maintains electronic records of treatment activity. These records can support workflow visibility, documentation and operational oversight.
For hospitals evaluating supplemental disinfection, important considerations include treatment effectiveness, compatibility with existing cleaning procedures, room availability, staff workflow and the ability to document completed treatments.