Even though Orange, Calif.-based UC Irvine Medical Center implemented a widely used strategy to contain methicillin-resistant Staphylococcus aureus in its neonatal intensive care unit, the bacteria still managed to spread to other infants in the NICU — meaning the containment strategy may not be as effective as experts believed.
MRSA first showed up in the hospital's NICU in December 2016, with seven infants affected. Once the superbug was discovered, UC Irvine Medical Center started universal decolonization of babies in the NICU, according to a Los Angeles Times report. Those steps included:
- Bathing infants with chlorhexidine
- Swabbing infants' noses with the antibiotic mupirocin
- Isolating infected babies
- Practicing hand hygiene
Susan Huang, MD, a professor of infectious disease at UC Irvine who closely studied MRSA, led the way in implementing universal decolonization. A study she co-authored in 2013 touts the practice. "[W]e found that universal decolonization prevented infection, obviated the need for surveillance testing, and reduced contact isolation," the study, published in the New England Journal of Medicine, concludes.
According to the LA Times, Dr. Huang said roughly 65 to 80 percent of hospitals use universal decolonization in their ICUs.
However, the tactic didn't seem to work at UC Irvine Medical Center, as MRSA spread to three more infants after the hospital implemented universal decolonization.
"We want the strategies we employ to work 100 percent of the time, but that's not always possible," Dr. Huang told the LA Times.
Even before this outbreak, other studies have pushed against using universal decolonization as a MRSA containment strategy and instead said universal testing, or active surveillance, would be more effective and efficient.