Successfully clearing discharged patients of methicillin-resistant Staphylococcus aureus: Opportunities for the prevention and containment of antimicrobial resistance

Abstract

Background: Australian hospitals routinely screen for multi-resistant organisms (MRO) to prevent the spread of healthcare-associated infection. The results of positive MRSA screening typically include: informing patient of their MRSA, single accommodation and contact precautions within the health care facility. These actions are associated with both negative and positive psychosocial effects, but also bring economic and human resource costs. MRSA clearance, however, is a less routine practice, and it is typically conducted only while patients are admitted. This paper reports the results of a study implementing a MRSA clearance program that included giving patients the opportunity to continue the clearance swabbing regime once discharged from hospital.

Methods: Retrospective cohort study of MRSA clearance between 2013 and 2016 at a private hospital in Australia.

Results: The MRSA clearance program was successful in increasing the MRSA clearance rate from 0 patients in 2013 to 13% (n12) in 2014, 11% (n10) in 2015, and 18% (n14) in 2016.

Conclusion: Allowing patients to continuing participation in MRSA clearance following discharge has increased the clearance rate of MRSA. Clearing patients of MRSAs is advantageous to patients, the health system and society, reducing health economic costs and the negative psychosocial effects associated with contact precautions.

Keywords: Antimicrobial resistance; Contact precautions; Extended spectrum beta-lactamase; MRSA; Methicillin-resistant Staphylococcus aureus; Multi-resistant organisms.