||Healthcare-associated infections due to antibiotic-resistant bacteria are costly and deadly. Michael Rubin, MD, and Matthew Samore, MD, generated new evidence on the effect of infection-prevention practices on the transmission of antibiotic-resistant pathogens, particularly methicillin-resistant Staphylococcus aureus (MRSA). They elucidated the epidemiological mechanisms for the progressive decline in rates of MRSA colonization and infection following the nationwide implementation of a program at Veterans Affairs healthcare facilities. The program introduced active surveillance to detect MRSA colonization in patients and placement of colonized patients on contact precautions, which involve the use of gowns and gloves by visiting healthcare workers. They used rigorous methods to evaluate the impact of this program and to model its cost-effectiveness, showing that the decrease in MRSA transmission that occurred following introduction of the program was largely due to contact precautions. Further, implementation of the program likely prevented a substantial number of infections from non-MRSA organisms, and was, therefore, highly cost-effective. Their studies generated important evidence for the role of contact precautions in preventing healthcare-associated infections, an issue of critical importance in healthcare epidemiology.
||1.) Vital Signs: Trends in Staphylococcus aureus Infections in Veterans Affairs Medical Centers - United States, 2005-2017. Jones M, Jernigan JA, Evans ME, Roselle GA, Hatfield, KM, Samore MH. MMWR Morb Mortal Wkly Rep. 2019 March 8;68(9):220.; 2.) Relationships between the importation, transmission, and nosocomial infections of methicillin-resistant Staphylococcus aureus: an observational study of 112 Veterans Affairs Medical Centers. Jones M, Ying J, Huttner B, Evans M, Maw M, Nielson C, Rubin MA, Greene T, Samore MH. Clin Infect Dis. 2014 January;58(1):32. 3.) Variation and trends in transmission dynamics of methicillin-resistant Staphylococcus aureus in Veterans Affairs hospitals and nursing homes. Khader K, Thomas A, Jones M, Toth D, Stevens V, Samore MH, the CDC Modeling Infectious Diseases in Healthcare Program. Epidemics. 2019 September;28:100347. 4.) Association between contact precautions and transmission of methicillin-resistant Staphylococcus aureus in Veterans Affairs hospitals. Khader K, Thomas A, Stevens V, Visnovsky L, Nevers M, Toth D, Keegan LT, Jones M, Rubin M Samore MH. JAMA Netw Open. 2021 March 1;4(3):e210971. 5.) Expanding an economic evaluation of the Veterans Affairs (VA) methicillin-resistant Staphylococcus aureus (MRSA) prevention initiative to include prevention of infections from other pathogens. Nelson RE, Goto M, Samore MH, Jones M, Stevens VW, Evans ME, Schweizer ML, Perencevich EN, Rubin MA. Clin Infect Dis. 2021 January 29;72(Supplement_1):S50. 6.) National estimates of healthcare costs associated with multidrug-resistant bacterial infections among hospitalized patients in the United States. Nelson RE, Hatfield KM, Wolford H, Samore MH, Scott RD, Reddy SC, Olubajo B, Paul P, Jernigan JA, Baggs J. Clin Infect Dis. 2021 January 29;72(Supplement_1):S17. 7.) Economic analysis of Veterans Affairs initiative to prevent methicillin-resistant Staphylococcus aureus infections. Nelson RE, Stevens VW, Khader K, Jones M, Samore MH, Evans ME, Douglas Scott, R 2nd, Slayton RB, Schweizer ML, Perencevich EL, Rubin MA. Am J Prev Med. 2016 May;50(5 Suppl 1):S58. 8.) The importance of contact precautions for endemic methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. Rubin MA, Samore MH, Harris AD. JAMA. 2018 March 6;319(9):863. 9.) Efficient parameter estimation for models of healthcare-associated pathogen transmission in discrete and continuous time. Thomas A, Redd A, Khader K, Leecaster M, Greene T, Samore M. Math Med Biol. 2015 March;32(1):79.