A man dies of septic shock due to a methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) only days after being admitted to your local hospital for a myocardial infarction. An initial quality improvement review reveals that the facility's rate of MRSA BSI is a lot higher than the national rate. What is going on?
S aureus is one of the most common pathogens in healthcare facilities and in the community, causing more than 100,000 BSIs and almost 20,000 deaths in 2017. Although the rates of hospital-onset (HO) MRSA BSIs had been decreasing up until 2012, the decline has slowed over the past 3 years.
Challenge yourself with this case representing a community hospital and see whether you would know what to do to reverse this trend.
A Distressing Finding
A 66-year-old man with a history of diabetes and coronary artery disease was admitted to a 400-bed suburban community hospital with chest pain, shortness of breath, and altered mental status. He was diagnosed with an ST-elevation myocardial infarction and underwent emergent cardiac catheterization with stent placement. He was subsequently admitted to the intensive care unit (ICU) and had a central venous catheter (CVC) placed. He remained hemodynamically unstable after his procedure.
