• Posted June 27, 2023

Infectious Disease Experts Update Rules on 'Superbug' Spread in Hospitals

“Superbug” infections are increasing in U.S. hospitals, and a coalition of medical groups has now issued a set of updated recommendations to protect patients.

These guidelines are meant to prevent the spread of methicillin-resistant Staphylococcus aureus, also known as MRSA, the authors of the recommendations argue.

MRSA causes about 10% of hospital-associated infections in the United States, and these infections are associated with an increased risk of death because the bug is resistant to common antibiotics.

Some infections caused by MRSA rose by as much as 41% during the pandemic, after falling in preceding years, researchers said.

“The enormous strain put on health care during the pandemic may have contributed to the observed increase in some hospital infections. We have data that show MRSA infections rose,” said senior guidelines author Dr. David Calfee, a professor of medicine at Weill Cornell Medical College in New York City.

The updated guidelines, published June 27 in the journal Infection Control & Hospital Epidemiology, are intended to counter that increase, Calfee added.

“The evidence that informs these recommendations shows that we can be successful in preventing transmission and infection,” Calfee said in a news release from the Society for Healthcare Epidemiology. “We can get back to the pre-2020 rates and then do even better.”

Hospital MRSA infections often follow invasive procedures like surgeries, the authors said, or the use of devices like needles or catheters that are inserted into the body. MRSA can spread throughout a hospital on the hands of health care personnel or through contact with contaminated surfaces and equipment.

The new recommendations place more emphasis on antimicrobial stewardship, which involves tight oversight over how antibiotics are prescribed and used.

Antimicrobial stewardship had been suggested as an “additional practice,” but the new guidelines call it an “essential practice” that all hospitals should perform.

A patient colonized with MRSA who is treated with antibiotics for another infection is more likely to develop a full-blown case of MRSA, the authors said. They then have a higher risk of transmitting their MRSA to others.

Another essential practice is the use of a gown and gloves when treating a patient colonized or infected with MRSA, the guidelines say, as well as hand hygiene and cleaning of surfaces.

“Basic infection prevention practices, such as hand hygiene and cleaning and disinfection of the health care environment and equipment, remain foundational for preventing MRSA,” Calfee said. “These fundamental practices help to prevent the spread of other pathogens as well.”

The guidance also promotes surveillance to detect MRSA carriers who haven't developed symptoms, as well as treatment to eradicate or reduce the burden of MRSA among people who are colonized with the antibiotic-resistant bug.

This guidance updates a 2014 strategy paper aimed at preventing MSRA transmission and infection in hospitals.

Five medical organizations collaborated to produce the new recommendations, including the Society for Healthcare Epidemiology, the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission.

More information

The U.S. Centers for Disease Control and Prevention has more on MRSA.

SOURCE: Society for Healthcare Epidemiology of America, news release, June 27, 2023