Resource Center
- BD Healthcare-Associated Infections Brochure
- Best Practice Guides & How-tos for Reducing Healthcare-Associated Infections
- Economic Models & Statistical Tools
- Peer-reviewed Scientific Journals & Related Publications
- International Guidance for MDRO- and MRSA-related Healthcare-Associated Infection Prevention
BD Healthcare-Associated Infections Brochure 
Best Practice Guides & How-tos for Reducing Healthcare-Associated Infections
Multidrug-resistant organisms are bacteria and other microorganisms that have developed resistance to antimicrobial drugs. A common example of this is methicillin-resistant Staphylococcus aureus (MRSA). MRSA is the most common healthcare-associated infection and is resistant to certain antibiotics, including methicillin and other more commonly used antibiotics (oxacillin, penicillin and amoxicillin). Most infections caused by MRSA are skin infections, but MRSA can also invade the blood and cause potentially serious complications such as bloodstream infections, infections of the joints and pneumonia.
In an effort to provide a comprehensive web resource for you in combating MDRO- and, specifically, MRSA-related HAIs, this section provides links to all National evidence-based guidelines intended for implementation in healthcare facilities.
Society for Healthcare Epidemiologists of America (SHEA)
SHEA Guideline for Preventing Nosocomial Transmission of Multidrug-Resistant Strains of Staphylococcus aureus and Enterococcus
The SHEA Guidelines have been developed to identify the reservoir for spread of MRSA and VRE infections across all healthcare settings to make control possible, using CDC/HICPAC's recommended contact precautions.
Centers for Disease Control and Prevention (CDC), Healthcare Infection Control Practices Advisory Committee (HICPAC)
Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002
A study conducted by the CDC provides a national estimate of the number of healthcare-associated infections and deaths in United States hospitals.
Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006
The CDC Healthcare Infection Control Practices Advisory Committee (HICPAC) recommends the implementation of an active surveillance testing approach when multidrug-resistant organism infections cannot be controlled with the use of appropriate barrier precautions and hand hygiene protocols.
Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, 2007
This updated guideline responds to changes in healthcare delivery and addresses new concerns about transmission of infectious agents to patients and healthcare workers in the United States and infection control. The primary objective of the guideline is to improve the safety of the nation's healthcare delivery system by reducing the rates of HAIs.
Guidelines for Environmental Infection Control in Healthcare Facilities, 2003
These guidelines provide environmental infection prevention strategies and practices for reducing environmental exposure to microbes; these include appropriate disinfection and sterilization; maintenance of durable medical equipment; water quality management; engineering controls; and others. Environmental surfaces continue to be sources of microbial contamination for those working in healthcare facilities, patients, and visitors.
Association for Professionals in Infection Control & Epidemiology (APIC)
Guide to the Elimination of Methicillin-Resistant Staphylococcus aureus (MRSA) Transmission in Hospital Settings
APIC provides effective efforts to elimination MRSA transmission that are guided by the completion of a comprehensive, facility-specific risk assessment which describes current state and characteristics of the MRSA burden for that facility or setting. The knowledge obtained from the risk assessment drives the development of interventions that result in enhanced compliance with existing facility practices, or in implementation of appropriate additional interventions.
Institute for Healthcare Improvement (IHI), Protecting 5 Million Lives from Harm Campaign
Reduce Methicillin-Resistant Staphylococcus aureus (MRSA) Infection How-to Guide
One of the primary goals of the 5 Million Lives Campaign is to significantly reduce MRSA infection by reliably implementing the five components of care recommended in this Guide.
Getting Started Kit: Prevent Central Line-Associated Bloodstream Infections How-to Guide
One of IHI's goal is to prevent catheter-related bloodstream infections by implementing the five components of care called the "central line bundle" discussed in this how-to guide. The five components of the "central line bundle" consist of hand hygiene, maximal barrier precautions, chlorhexidine skin antisepsis, optimal catheter site selection, and daily review of line necessity with prompt removal of unnecessary lines.
Getting Started Kit: Governance Leadership "Boards on Board" How-to Guide
IHI's goal is to have the Boards of Trustees in all hospitals undertake the six key governance leadership activities to improve quality and reduce harm in their hospitals recommended in this Guide. At a minimum, boards should start spending more than 25% of their meeting time on quality and safety issues and conducting, as a full board, a conversation with at least one patient, or family member of a patient, who sustained serious harm at their institution within the last year.
Quick Chart: Comparison of Guides and How-tos
Economic Models & Statistical Tools
Health Outcomes Impact of Screening Test Methodology on MRSA Transmission Rates 
This model calculates projected MRSA transmissions and subsequent MRSA infections in the ICU based on rates found in the Cunningham and Davis papers. As a result of the more rapid identification of MRSA carriers via the PCR screening method, infection control interventions are implemented sooner, and more MRSA transmissions are avoided, and thus, more MRSA infections are avoided - this impact is calculated in this model.
Dispelling the Myths: The True Cost of Healthcare-Associated Infections
The Association for Professionals in Infection Control and Epidemiology (APIC) presents the business case for reducing healthcare-associated infections from the perspective of the healthcare executive. Case studies of significant cost savings are presented along with methodology for determining the cost of various categories of HAIs.
Statistical Analysis Tools for the Fisher's Exact Test and Standardized Infection Ratio (SIR) These tools will allow you to analyze your own infection rates.
Epi Info™
Epi Info™ is a public domain software package designed for the global community of public health practitioners and researchers. It provides for easy form and database construction, data entry, and analysis with epidemiologic statistics, maps, and graphs.
Simple Interactive Statistical Analysis (SISA)
SISA is a collection of procedures to do simple interactive statistical calculations on the Internet. SISA is meant to give practitioners access to a variety of statistical tools for analyzing the data they collect in their daily work. Medical Doctors, Engineers, Nurses, Social Workers, Valuators, Sociologists, Builders, Market researchers, and of course Statisticians too, are among those who can benefit from using this tool.
Peer-reviewed Scientific Journals & Related Publications
Klein, E., Smith, D.L., & Laxminarayan, R. (2007). Hospitalizations and deaths caused by methicillin-resistant Staphylococcus aureus, United States, 1999-2005. Emerging Infectious Diseases, 13(12), 1840-1846.
Hospital-acquired infections with Staphylococcus aureus, especially methicillin-resistant Staphylococcus aureus (MRSA) infections, are a major cause of illness and death and impose serious economic costs on patients and hospitals. However, the recent magnitude and trend of these infections have not been reported.The authors used national hospitalization and resistance data to estimate the annual number of hospitalizations and deaths associated with Staphylococcus aureus and MRSA from 1999 through 2005.
Farr, Barry M. (2007). Political versus epidemiological correctness. Infection Control and Hospital Epidemiology, 28(5), 589-593.
Dr. Farr offers his perspective on the recent position statement from the Joint SHEA and APIC Task Force regarding legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE).
Fraser, V., Murphy, D., Brennen, P.J., Frain, J., Arias, K.M., Perl, T. et al. (2007). Politically incorrect: Legislation must not mandate specific healthcare epidemiology and infection prevention and control practices. Infection Control and Hospital Epidemiology, 28(5), 594-595.
A response to Dr. Farr's position on legislative mandates for the use of active surveillance cultures to screen for MRSA and VRE is provided by a broad range of experts and the Boards of Directors of the Society for Healthcare Epidemiology (SHEA) and the Association of Professionals in Infection Control (APIC).
Hardic, F.E., Pasculle, A.W., & Muto, C.A. (2006, May). Screening for nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA): Reduction of turnaround time and workload by the use of BBL™ CHROMagar MRSA. Poster session presented at the annual meeting of the American Society for Microbiology, Orlando, FL. 
This poster abstract, presented by Dr. A. William Pasculle at the American Society for Microbiology's annual meeting in May, 2006, compares the performance of the BD BBL™ CHROMagar™ MRSA to the combination of blood agar and mannitol salt agar with oxacillin, which was routinely used in the University of Pittsburgh Medical Center's laboratory.
International Guidance for MDRO- and MRSA-related Healthcare-Associated Infection Prevention
Screening for Methicillin-resistant Staphylococcus aureus (MRSA) colonisation
The Department of Health presents recommendations, if implemented, that will reduce the risk of infection from MRSA through screening patients identified as "at risk" from MRSA colonization.
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