Program aims to cut staph at VA facilities

A pilot project at the Veterans Affairs Pittsburgh Healthcare System to reduce the prevalence of an antibiotic-resistant bacteria has grown into a nationwide initiative to eradicate the organism throughout all VA hospitals.

Dr. Rajiv Jain, chief of staff at the VA Pittsburgh Healthcare System, is leading the project to reduce -- and eventually eliminate -- infections caused by methicillin-resistant staphylococcus aureus (MRSA).

VA hospitals in 17 cities will follow the lead of VA Pittsburgh, which has greatly reduced such staph infections in its facility.

"This is so exciting," Jain said. "One of the reasons is there are other quality improvement programs we're involved in. ... In this one, we not only are improving the safety and health and welfare of the patients, but also saving money."

MRSA causes maladies such as skin infections and pneumonia and kills in some cases. The organism is found on the skin or in the nose and is spread primarily through contact with an infected person or object carrying it.

MRSA is resistant to methicillin, an antibiotic that's usually administered to treat infections. Vancomycin, a powerful antibiotic considered a drug of last resort, is used to treat MRSA, but Jain said the bacteria has begun showing signs of resisting it, too, making the VA project even more important.

Each infection can cost a hospital tens of thousands of dollars.

"The only way to defeat MRSA is to tackle the transmission," said Peter Perreiah, managing director of the Pittsburgh Regional Healthcare Initiative, which along with the U.S. Centers for Disease Control and Prevention was involved in the pilot project. "It's doing a thousand things right when you're caring for patients."

VA Pittsburgh implemented a plan to identify MRSA in its surgical unit four years ago. At the time, Jain said, the facility treated about 20 MRSA cases a year. The project reduced the number to one or two, a success that prompted the hospital to expand its MRSA-prevention plan throughout the facility.

VA Pittsburgh tests every patient for MRSA upon admission and discharge by taking cultures from their noses. That enables the facility to determine if patients contracted MRSA while at the hospital or arrived with it.

Select VA hospitals across the country will implement similar plans in one section of their facilities. If they experience the same success as VA Pittsburgh, Jain said, they will go hospitalwide.

Jain hopes to include every VA hospital in the country in the project within two years.

"It's endemic in our environment," Jain said. "All nursing homes and hospitals have some patients or staff who are carriers or are infected with this organism.

"To us, even one infection seemed unnecessary."