Targeted versus Universal Decolonization to Prevent ICU Infection

Prevention of nosocomial infection, especially with MRSA, is a high priority. In this trial involving 74 ICUs at 43 hospitals, universal decolonization with the use of chlorhexidine and mupirocin was associated with a decrease in all-cause bloodstream infections. Health care–associated infection is a leading cause of preventable illness and death and often results from colonizing bacteria that overcome body defenses. 1 – 5 Among the pathogens causing health care–associated infection, methicillin-resistant Staphylococcus aureus (MRSA) has been given priority as a target of reduction efforts because of its virulence and disease spectrum, multidrug-resistant profile, and increasing prevalence in health care settings, particularly among patients in the intensive care unit (ICU). Hospitals commonly screen patients in the ICU for nasal carriage of MRSA and use contact precautions with carriers. 2 – 6 Nine states mandate such screening. 7 Decolonization has been used to reduce transmission . . .