Source/Disclosures
sources:
Schroeder J, et al. Effects of decolonization protocols in pediatric critical care populations. Presented at: APIC 2023; June 16-28, 2023; Orlando.
Disclosures:
Schroeder reports no relevant financial disclosures.
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Key takeaways:
- The hospital reduced rates of hospital-onset MRSA and hospital-onset MRSA bacteremia.
- The protocols were implemented in three intensive care units.
ORLANDO – A children’s hospital used decolonization protocols to drive down rates of MRSA in three intensive care units by more than 40%, according to data reported at a medical conference.
Although the idea for the study first came about in 2019, the COVID-19 pandemic caused delays in the project, according to one of its authors.
“As 2020 went on, we were starting to see our MRSA rates increasing in our hospital and it’s becoming noticeable,” Jennifer Schroeder, MPH, CIC, lead infection preventionist at Children’s Hospital New Orleans and co-author of the study, told Healio. “We were seeing rates that we really haven’t seen before, so we assembled our teams to deep dive and look at what we could do.”
Although decolonization protocols were in place for adults in the hospital’s health system, no such plans had been made for the children’s hospital, Schroeder said.
Schroeder and her colleagues in infection prevention met with other staff to develop and implement the protocols in the hospital’s cardiac ICU, NICU and pediatric ICR. These protocols included a nasal decolonization regimen being used in adult patients, which involved regular nostril swabbing with an antibacterial ointment in addition to standard use of chlorhexidine gluconate bathing.
During a preintervention phase between January and October 2021, there were 2,316 admissions totaling 15,765 patient days, with an average stay length of 6.8 days. In the post-intervention period from November 2021 to August 2022, there were 2,778 admissions and 17,296 patient days, with an average length of stay of 6.2 days, a reduction from the pre-intervention phase.
The MRSA rate per 1,000 patient days in the three intensive care units decreased from 1.459 to 0.867 after the protocols were implemented — a decrease of around 41% — and its hospital-onset MRSA bacteremia rate per 1,000 patient days decreased 54% from 0.381 to 0.173 .
Schroeder said further research is needed into protocols to prevent MRSA in pediatric populations.
“Why are we not figuring out ways when we see best practices that are guided toward the adult patient population?” Schroeder said. “Why are we not thinking, ‘How do we implement this in a pediatric population as well?’ Kids get sick, they go to the hospital, just like adults, they’re at risk for infection — why are we not doing what the literature has shown to do in adults?”
She added that such protocols can and should be expanded to “other health care facilities,” as well as globally.
“I would like this to go forward as a standard practice,” Schroeder said.
References:
New Orleans infection preventionists adapt adult protocols to reduce infections in babies. https://www.eurekalert.org/news-releases/993066. Published June 26, 2023. Accessed June 26, 2023.
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