April 30, 2007
Michael E. DeBakey VA Medical Center is the first hospital in Texas, not to mention the VA, to install a computerized system able to integrate all the steps required for surveillance MRSA testing: sample preparation, amplification, and detection.
HOUSTON – As part of its fight against Methicillin-Resistant Staphylococcus aureus (MRSA), the Michael E. DeBakey VA Medical Center (MEDVAMC) is the first hospital in Texas and in the Department of Veterans Affairs to install a computerized system able to integrate all the steps required for surveillance MRSA testing: sample preparation, amplification, and detection.
MRSA is a more serious form of a common bacteria that frequently inhabits the skin or nostrils of healthy people. Due to its resistance to antibiotics commonly used in treatment, MRSA is one of the most rapidly growing and virulent health care associated infections, and according to the Centers for Disease Control and Prevention (CDC), is responsible for over 100,000 U.S. hospitalizations each year.
The new computerized system at the MEDVAMC utilizes real-time polymerase chain reaction (PCR) to amplify and detect target bacteria. Designed to simplify hands-on preparation, the system provides PCR test results from a raw sample in 70 minutes or less, enabling time-critical bacteria tests at the point of care. Current techniques for accomplishing this same series of procedures require extensive labor by skilled laboratory professionals and can take hours to several days to deliver results.
“A key factor with this new system is now we have “on-demand” capabilities. Testing can occur at any time, on any day. This quick turn-around will give us actionable results in minutes and will decrease the window for potential transmission of MRSA,” said Patricia A. Byers, R.M., M.(A.S.C.P.), C.I.C., MEDVAMC Infection Control practitioner.
Anyone can get a MRSA infection, but the risk is greatest among people treated in hospitals and health care facilities, such as nursing homes and dialysis centers, with weakened immune systems. These health care-associated staph infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia.
MRSA is primarily spread by direct physical contact with a person or object carrying the bacteria, such as shared equipment. In the hospital setting, the most common vector of transmission is health care workers’ hands.
When MRSA is introduced into a hospital, it tremendously increases the total burden of infection for the patient and increases the risk of death four-fold. These patients have hospital stays lasting more than two and a half times longer than the average patient.
The MEDVAMC has teamed up with 18 other VA medical facilities for the VA MRSA Prevention Initiative, “Getting to Zero.” Through pilot studies conducted at the VA Pittsburgh Healthcare System focusing on enhancing MRSA control, the major barriers to effective MRSA prevention were identified. The war on MRSA in Pittsburgh VA facilities has succeeded in reducing the hospital’s MRSA infection cases from 20 per year to as few as two per year.
“As the only VA with this new cutting-edge technology, the Michael E. DeBakey VA Medical Center is eager to use this critical tool to improve health care and safety for our veterans,” said Thelma Gray-Becknell, R.N., M.S.N., MEDVAMC chief nurse executive.
As a result of the pilot studies, the VA developed the “MRSA Bundle” as a packaged prevention strategy. These measures include (1) Active Surveillance cultures (swabbing performed on admission, discharge, and transfer within the hospital); (2) Hand Hygiene (before and after patient contact); (3) Contact Precautions (gloves and gowns); and (4) Cultural Transformation (staff and leadership engagement).