Multicomponent MRSA Program Reduces Hospital Infection Rates

A national quality-improvement program was associated with substantial reductions in hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and other health care-associated infections, according to a study published in JAMA Network Open.

The Agency for Healthcare Research and Quality Safety Program for MRSA Prevention was implemented in 94 US acute-care hospitals, including 106 intensive care units and 87 non-intensive care units. The program combined 22 webinars and durable educational materials with implementation support for chlorhexidine bathing, nasal MRSA decolonization, environmental disinfection, prevention of person-to-person transmission, and device-related infection prevention.

Compared with the previous 12-month baseline, laboratory-identified hospital-onset MRSA bacteremia decreased by 2.3 events per 10,000 patient-days, a 65% relative reduction (P<.001). Hospital-onset clinical cultures growing MRSA decreased by 39%, all-cause hospital-onset bacteremia by 37%, and central line-associated bloodstream infections by 31% (P<.001). All reported changes were statistically significant.

The authors cautioned that the before-and-after design lacked a contemporaneous control group and could have been affected by volunteer participation and secular trends. Several outcomes had begun to decline before formal implementation, and clinical outcomes were self-reported. The participating units also received substantial support, which may limit generalizability.

The study shows that a structured, multicomponent implementation program can coincide with substantial infection reductions, but it does not establish that the program alone caused the changes.

Source: Maragakis LL, Miller MA, Gao Y, et al. Hospital-onset methicillin-resistant Staphylococcus aureus prevention in acute care hospitals. JAMA Netw Open. 2026;9(8):e2631225. doi:10.1001/jamanetworkopen.2026.31225