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IV Drug Use Seen as Biggest Emerging Risk Factor for MRSA

Sixty percent of hospitals studied received low scores for managing MRSA infections

With the rate of the most common form of methicillin-resistant Staphylococcus aureus (MRSA) infection falling in hospitals but remaining steady in the community, the biggest emerging risk factor for infection is intravenous (IV) drug use, according to a study published in Infection Control & Hospital Epidemiology.

Community-associated MRSA, or CA-MRSA, initially emerged among children in day care, athletes, military personnel, and prisoners; close physical contact was thought to spread the germ. Now, risk factors include living in public housing, high-risk sexual behaviors, human immunodeficiency virus infection, and illicit drug use, according to the findings.

Illicit drug use was a significant factor for both community-acquired and hospital-onset MRSA (HO-MRSA). Researchers speculated that drug users already had MRSA when they entered the hospital.

The researchers concluded the USA300 strain of MRSA is endemic in both hospital and community settings, Fierce Healthcare reports. USA300 is now more common in hospitals than the traditional hospital-acquired USA100 MRSA strain. Researchers concluded that preventive efforts focusing on illicit drug users might be required to curb MRSA infections.

The study was conducted at Cook County Hospital in Chicago, a large safety-net hospital serving a highly diverse urban population. Researchers noted that population might limit the degree to which the findings can be generalized across other hospital settings. But with similar rates of USA300 infection among U.S. inner-city populations, "the evolving epidemiology of USA300 that we demonstrated may be found in other areas."

Although the rate of hospital-onset MRSA infections has fallen in recent years, about 60% of 3,000 hospitals studied nationwide received the lowest or next-to-lowest scores for managing MRSA infections in a recent Consumer Reports study. However, 322 of the hospitals, or about 10%, reported zero MRSA infections, the study found.

Last year several prominent infection-control and health care organizations jointly released a set of strategies for reducing the spread of MRSA and guidance for prioritizing actions. The strategies included conducting a risk assessment, identifying ways to pinpoint patients with a history of MRSA and to track hospital-acquired infections, ensuring compliance with hand-hygiene and physical contact protocols, and implementing an alert system to quickly contain infections.

Source: Fierce Healthcare; September 17, 2015.

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