1749. Eight Years of Decreased Methicillin-Resistant Staphylococcus aureus (MRSA) Healthcare-Associated Transmissions (Tx) and Infections (HAI) Associated with a Veterans Affairs Prevention Initiative
Session: Oral Abstract Session: MRSA Prevention and Epidemiology
Saturday, October 29, 2016: 9:30 AM
Room: 288-290

Background:  MRSA Tx and HAI rates declined in VA facilities since inception of the MRSA Prevention Initiative in 2007 and were reported in acute care facilities (2012), spinal cord injury units (SCIU, 2011), and long-term care (LTCF, 2012) facilities.  Here we report MRSA Tx and HAI rates over the first 8-years of the program (October 2007-Sepember 2015) which includes an additional 39, 51, and 33 months of data from these three settings, respectively.

Methods:  Monthly data entered into a national database from 127 acute care facilities, 133 LTCFs, and 22 acute care SCIUs were evaluated for trends using negative binomial regression.

Results:  In VA acute care facilities nationwide during the 8-year analysis period, there were 5,530,104 admissions/transfers/discharges and 23,153,240 patient(pt)-days in intensive care units (ICU) and non-ICUs; 71,170 admissions/transfers/discharges and 1,794,234 patient-days in SCIUs, and 312,541 admissions and 22,262,605 resident(res)-days in LTCFs from July 2009 through September 2015.  Facility and unit admission/transfer/discharge swabbing compliance remained >92% in all three venues.  Admission prevalence increased from 13.2%-13.5% in acute care overall and 23.1%-25.0% in LTCFs and decreased from 35.1%-32.0% in SCIUs during the analysis periods.  Monthly MRSA ICU transmission rates fell 35.2% (3.15-2.04/1000 pt-days, P<.0001) and HAI rates 96.1% (1.42- 0.06/1000 pt-days, P<.0001); acute care non-ICU transmission rates fell 22.9% (2.34-1.80/1000 pt-days, P<.0001) and HAI rates 79.6% (0.46-0.09/1000 pt-days, P<.0001); acute care SCIU transmission rates fell only 0.4% (1.45-1.44/1000 pt-days, P =0.80) but HAI rates fell 83.9% (1.36-0.22/1000 pt-days, P<.0001), and LTCF HAI rates fell 69.6% (0.33-0.10/1000 res-days, P<.0001)(data were not analyzed for Tx).  In September 2015, there were only two MRSA HAIs in ICUs, 20 (with 3 in SCIUs) in non-ICUs, and 31 in LTCFs reported nationwide. 

Conclusion: MRSA Tx rates significantly declined in VA ICUs and non-ICUs but not in SCIUs.  MRSA HAI rates significantly declined in acute and long-term care facilities and spinal cord injury units over eight years of the VHA MRSA Prevention Initiative.

 

 

Martin Evans, MD, FIDSA, FSHEA1, Stephen Kralovic, MD, MPH, FSHEA2, Loretta Simbartl, MS2, Rajiv Jain, MD3 and Gary Roselle, MD, FIDSA4, (1)Division of Infectious Diseases, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY, (2)National Infectious Diseases Service, Department of Veterans Affairs, Washington, DC, (3)Department of Veterans Affairs, Veterans Health Administration Central Office Patient Care Services, Washington, DC, (4)National Infectious Diseases Service, Patient Care Services, Veterans Affairs Central Office, Cincinnati, OH

Disclosures:

M. Evans, None

S. Kralovic, None

L. Simbartl, None

R. Jain, None

G. Roselle, None

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