The MRSA bacterium is resistant to multiple drugs and is often spread in hospitals. Healthcare experts have been torn over how to best to treat the problem, Wired.com reported.
One common strategy in Europe and some parts of the United States is to identify which patients are carrying the pathogen and isolate them. This strategy is called "active detection and isolation."
A more general strategy is to enforce sanitary conditions in the hospital, such as health care workers washing their hands regularly and giving patients frequent disinfecting baths.
The "active detection and isolation" approach has been thought to be more effective and has already been incorporated into law in nine states. However, it's not cost efficient and uses up more resources and staff time.
A recent study published in the New England Journal of Medicine conducted a trial of both prevention systems. They concluded that the general strategy actually worked better than "active detection and isolation." The general strategy was also found to be more efficient at preventing the spread of other infections from patient to patient.
The study was conducted over the course of 18 months and encompassed 43 hospitals within the Hospital Corporation of America system, and looked at over 74,000 patients.
Patients were each given one of three treatments. These were: active detection and isolation, in which patients were tested from the bacterium and isolated with healthcare workers using protective gear; targeted decolonization, where the patients were tested and precautionary measures were taken to prevent the spread of those carrying the bacterium such as disinfectant baths; or universal decolonization, where nobody was tested but every ICU patient was given mupirocin and chlorhexidine as precautionary measures.
The most successful method turned out to be universal decolonization, which reduced MRSA positive patients by 37 percent. It also reduced all pathogens in the bloodstream by 44 percent.
The method that, surprisingly, proved to be the least effective was the popular "active detection and isolation" system, which made almost no difference in the amount of pathogens in the blood stream.
"Several factors may account for our observation that universal decolonization had a greater preventive effect than the two other strategies," stated the authors of the study. "First, chlorhexidine reduces skin colonization by many pathogens, thus protecting patients in the ICU from their own microbiota during a period of heightened vulnerability to infection. Second, universal decolonization reduces the environmental microbial burden, reducing opportunities for patient-to-patient transmission. Third, universal decolonization began on the first ICU day, thus avoiding the delay in decolonization pending the results of screening tests,"
