MRSA infection rates drop in Veterans Affairs long-term care facilities


Washington, DC, January 6, 2014 – Four years after implementing a national initiative to reduce methicillin-resistant Staphylococcus aureus (MRSA) rates in Veterans Affairs (VA) long-term care facilities, MRSA infections have declined significantly, according to a study in the January issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

The MRSA Prevention Initiative, implemented nationwide in 133 VA long-term care facilities in 2009, led to a 36 percent overall decrease in MRSA infections (from .25 to .16/1000 resident days) over the 42-month study period, despite the fact that admissions with MRSA colonization increased. 

The MRSA Prevention Initiative utilizes a bundled approach that includes screening every patient for MRSA, use of gowns and gloves when caring for patients colonized or infected with MRSA, hand hygiene, and an institutional culture change focusing on individual responsibility for infection control. It also created the new position of MRSA Prevention Coordinator at each center. 

Residents in long-term care facilities are at risk for infections with multidrug-resistant organisms, and infectious organisms can be difficult to control when introduced into these settings. Because of concerns about MRSA prevalence in long-term care, the VA expanded the MRSA Prevention Initiative into the VA’s 133 long-term care facilities throughout the U.S. The initiative had already shown dramatic success in reducing MRSA healthcare-associated infection (HAI) rates in acute care hospitals.

“We previously reported that a MRSA Prevention Initiative was associated with significant decreases in MRSA HAIs in acute care facilities over a 33-month period in a large healthcare system. Here we show that the initiative was also associated with decreased rates of MRSA HAIs in VA community living centers (CLCs) without a corresponding decrease in MRSA admission prevalence,” state the authors. “To our knowledge, declines in MRSA HAIs such as this have not been reported in other large long-term care settings. Our experience suggests that adherence to a simple bundle of infection prevention and control strategies may be of value in controlling MRSA HAIs in CLCs, especially if the program is implemented widely throughout the network of healthcare venues in which an individual may seek care.”

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that is resistant to many antibiotics. In the community, most MRSA infections are skin infections. In medical facilities, MRSA causes life-threatening bloodstream infections, pneumonia, and surgical site infections.


AJIC: American Journal of Infection Control (www.ajicjournal.org) covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, AJIC is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. Published by Elsevier, AJIC is included in MEDLINE and CINAHL.



APIC’s mission is to create a safer world through prevention of infection. The association’s more than 15,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at www.apic.org. Follow APIC on Twitter: http://twitter.com/apic and Facebook: www.facebook.com/APICInfectionPreventionandYou. For information on what patients and families can do, visit APIC’s Infection Prevention and You website at www.apic.org/infectionpreventionandyou.  



“Nationwide reduction of health care-associated methicillin-resistant Staphyloccoccus aureus infections in Veterans Affairs long-term care facilities” by Martin E. Evans, Stephen M. Kralovic, Loretta A Simbartl, Ron W. Freyberg, D. Scott Obrosky, Gary A. Roselle, and Rajiv Jain appears in the American Journal of Infection Control, Volume 42, Issue 1 (January 2014). 


Martin E. Evans, MD (corresponding author)

VHA MRSA/MDRO Program Office, The National Infectious Diseases Service, Patient Care Services, VA Central Office and the Lexington VA Medical Center

Lexington, KY


Stephen M. Kralovic, MD, MPH

National Infectious Diseases Service, Patient Care Services, VA Central Office and Cinicinatti VA Medical Center

Cincinnati, OH


Loretta A. Simbartl, MS

National Infectious Diseases Service, Patient Care Services, VA Central Office and Cinicinatti VA Medical Center

Cincinnati, OH


Ron W. Freyberg, MS

VA Office of Informatics and Analytics, Analytics and Business Intelligence

Cincinnati, OH


D. Scott Obrosky, MS

Center for Health Equality Research and Promotion, VA Pittsburgh Healthcare System

Pittsburgh, PA


Gary A. Roselle, MD

National Infectious Diseases Service, Patient Care Services, VA Central Office and Cinicinatti VA Medical Center

Cincinnati, OH


Rajiv Jain, MD

Patient Care Services, VA Central Office

Washington, DC



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