549. MethiciIlin Resistant Staphylococcus aureus Screening Evolution: From Targeted to Total Patient Surveillance in a VA Hospital
Session: Poster Abstract Session: MRSA Surveillance and Infection Prevention
Friday, October 21, 2011
Room: Poster Hall B1

Background: In 2007 the Department of Veterans Affairs (VA) implemented a nationwide MethiciIlin Resistant Staphylococcus aureus (MRSA) initiative utilizing bundled interventions including MRSA screening for all admissions. Ahead of the curve, the Madison VA began targeted MRSA screening two decades earlier. Here we describe the evolution of MRSA screening from targeted to total surveillance and its effect on MRSA hospital-acquired infection (HAI) rates.  

Methods: The Madison VA began targeted MRSA surveillance (i.e., screening cultures for hospital transfers) in the mid-80's through 2004. Targeted MRSA surveillance was expanded to include recent hospitalizations within 30 days in 2005. In 2007, screening of all ICU admissions was added to the target population. Finally in 2008, the Madison VA began MRSA screening on all hospital admissions as did all VA nationwide.  Poisson regression analysis was done to compare the rates over time.

Results: As the screening program evolved from targeted to total patient surveillance, the HAI MRSA rates progressively declined between FY03 to FY10; 1.40, 0.98, 0.87, 0.87, 0.48, 0.29, 0.30, and 0.29, respectively (p < 0.0001).  MRSA HAI rates between FY03- FY10 with corresponding screening populations are described in Figure 1


Conclusion: The rate of MRSA-HAI progressively decreased as the number of patients included in MRSA screening program progressively increased. The number of patients included in the MRSA screening program positively correlates with a decrease in MRSA-HAI at the Madison VA. 


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Linda McKinley, RN, MPH1, Kathy Matteson, RN, MSN2, Cathy Stampfli, RN, BSN2, Christopher Crnich, MD, MS3 and Nasia Safdar, MD, PhD3, (1)Infectious Disease, Madison VA Medical Center, Madison, WI, (2)Madison VA Medical Center, Madison, WI, (3)Section of Infectious Diseases, University of Wisconsin School of Medicine and Public Health, Madison, WI


L. McKinley, None

K. Matteson, None

C. Stampfli, None

C. Crnich, None

N. Safdar, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.