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Hospital Acquired Infections: MRSA, C-Diff and CLABSI


Methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C-diff), and Central line-associated bloodstream infections (CLABSI) are three common superbugs that are threats to patients in hospital and healthcare settings. Both bacteria have become resistant to common antibiotics and can cause serious health concerns. Recent advancements have been found in an effort to control these infections.

Although MRSA is better known to the general public, a study of 28 hospitals in the US Southeast by researchers from Duke University have found that infections from C-diff are surpassing MRSA as the biggest germ threat to hospitalized patients.

Dr. Becky Miller, an infectious diseases specialist at Duke, looked at infection rates in 2008 to 2009 from community hospitals in Virginia, North Carolina, South Carolina and Georgia. Hospital acquired C-difficile infections have been increasing since 2005 and the number of infections is now 25% higher than MRSA. Although deaths from C-diff have been considered rare, a more dangerous form of the bacteria has emerged over the past decade.

C-difficile is bacteria found in the colon and can cause diarrhea and a more serious intestinal condition known as colitis. It is spread by spores in feces that are difficult to kill with most conventional cleaners or alcohol-based sanitizers. A recent report from Pennsylvania Patient Safety Advisory shows that almost 40% of gastrointestinal infections reported from nursing homes are due to C-diff and another study to be published in the April journal Emerging Infectious Diseases show that the infection is increasing in hospital pediatric wards.

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Mayo Clinic researchers have found a reliable method to reduce the number of C-diff infections in healthcare facilities. The process involves consistent daily cleaning of all high-touch surfaces with a spore-killing bleach disinfectant wipe. The findings were presented at a conference sponsored by the Society for Healthcare Epidemiology of America, the Infectious Disease Society of America, and the Centers for Disease Control and Prevention (CDC).

Methicillin-resistant Staphylococcus aureus are bacteria that are often harmless as they come in contact with intact skin, but can enter through wounds and may become deadly once they reach the bloodstream. MRSA infections cause about 18,000 deaths each year due to pneumonia or sepsis, but the CDC reports that the rate of infections have fallen over the past 10 years due to improved infection control surveillance programs and techniques.

One new technique studied by researchers from Harborview Medical Center in Seattle and published in the March issue of the Archives of Surgery have found that bathing critically ill patients daily with cloths containing 2% chlorhexidine gluconate reduces MRSA infections along with some other hospital-acquired infections such as Acinetobacter.

The March 2010 Pennsylvania Patient Safety Advisory also describes the high risk of infection to patients who have central lines or central venous catheters placed for long-term intravenous access. If these are not cleansed properly, bacteria can enter the line, spread, and lead to a bloodstream infection. The report cites 2008 data from the CDC which estimates that the cost of one CLABSI in the US is about $29,156. The national average for CLABSI infections are 2 for every 1,000 days a catheter is in place.

The best practice for preventing hospital-acquired infestions like CLABSI include using sterile barriers to prevent infection, using chlohexidine to prepare the catheter site, and daily reviewing of the catheter location for signs of infection.

This page is updated on April 18, 2013.
USA Today, Pennsylvania Patient Safety Authority