(HealthDay News) – Universal decolonization seems to be more effective than targeted decolonization or screening and isolation for preventing health care-associated infections, according to a study published online May 29 issue of the New England Journal of Medicine.

Susan S. Huang, MD, MPH, from the University of California Irvine School of Medicine in Orange, and colleagues randomized 43 hospitals to one of three strategies to prevent health care-associated infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA). All adult intensive care units within a hospital were assigned to the same strategy. The three strategies implemented were MRSA screening and isolation; targeted decolonization; and universal decolonization.

The researchers found that, compared with the baseline period, during the intervention period, the modeled hazard ratios for MRSA clinical isolates were 0.92 for screening and isolation, 0.75 for targeted decolonization, and 0.63 for universal decolonization. The corresponding hazard ratios for bloodstream infection with any pathogen were 0.99, 0.78, and 0.56. A significantly greater reduction was noted in the rate of all bloodstream infections with universal screening vs. either targeted decolonization or screening and isolation. The reductions in the rates of MRSA infections were similar to those of all bloodstream infections, but the difference was not significant.

“We found that universal decolonization prevented infection, obviated the need for surveillance testing, and reduced contact isolation,” the authors conclude.

One author disclosed financial ties to 3M; several authors disclosed financial ties to Sage Products.

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