Update of strategies to prevent MRSA transmission, infection in acute care hospitals

Editor's Note

This expert guidance document, sponsored by the Society for Healthcare Epidemiology of America (SHEA), updates the “Strategies to Prevent Methicillin-Resistant Staphylococcus aureus [MRSA] Transmission and Infection in Acute Care Hospitals” that were published in 2014.

Among the updates:

• Recommendations are now categorized as Essential Practices that should be adopted by all acute-care hospitals or Additional Approaches that can be considered for use in locations and/or populations within hospitals when MRSA transmission or infection is not controlled after implementation of Essential Practices. Essential Practices were termed “Basic Practices” and Additional Approaches were termed “Special Approaches” in the 2014 publication.
• Antimicrobial stewardship has been reclassified to an Essential Practice, and contact precautions remain an Essential Practice, though there are considerations for hospitals to modify contact precautions if they have strong horizontal prevention measures and no ongoing, high, or increasing rates of MRSA or hospital-onset MRSA-positive cultures.
• Active surveillance testing and decolonization therapy remain Additional Approaches, but recommendations, supporting data, and quality-of-evidence ratings for their use in several specific populations have been added.

The document is the product of a collaborative effort led by SHEA, Infectious Diseases Society of America, Association for Professionals in Infection Control and Epidemiology, American Hospital Association, The Joint Commission, and others.