Author Interviews, Emory, Infections, JAMA, MRSA / 10.10.2023
Emory/CDC Study Finds Combination Strategy Reduces Hospital Acquired Staph Infections
MedicalResearch.com Interview with:
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Dr. Jernigan[/caption]
Dr. John Jernigan, MD MS
Clinical Associate Professor of Medicine
Division of Infectious Diseases
Emory University School of Medicine
Branch Chief
Epidemiology, Research and Innovations Branch
CDC Center for Disease Control
MedicalResearch.com: What is the background for this study?
Response: Staphylococcus aureus commonly causes infections in ICUs. One approach to preventing these infections is using nasal mupirocin plus chlorhexidine gluconate (CHG) bathing for ICU patients. This practice is known to prevent methicillin-resistant Staphylococcus aureus (MRSA) infections and all-cause. bloodstream infections. This practice has been broadly adopted in ICUs in the US, but adoption of mupirocin as a universal topical antibiotic has been slowed by concerns for engendering mupirocin resistance.
This cluster-randomized trial in adult ICUs was conducted to assess whether universal nasal antiseptic povidone-iodine (iodophor), to which minimal S. aureus resistance is expected, was an acceptable alternative to universal nasal mupirocin for reducing S. aureus and MRSA clinical cultures in the setting of daily CHG bathing. Those who received chlorhexidine (CHG) bathing with mupirocin had an 18% reduction in risk of Staphylococcus aureus clinical cultures and a 15% reduction in risk of methicillin-resistant S. aureus (MRSA) clinical cultures compared to patients who received CHG bathing with intranasal iodophor. These results show that using mupirocin for nasal decolonization may be preferred over iodophor because it is more effective at preventing S. aureus infections.
Dr. Jernigan[/caption]
Dr. John Jernigan, MD MS
Clinical Associate Professor of Medicine
Division of Infectious Diseases
Emory University School of Medicine
Branch Chief
Epidemiology, Research and Innovations Branch
CDC Center for Disease Control
MedicalResearch.com: What is the background for this study?
Response: Staphylococcus aureus commonly causes infections in ICUs. One approach to preventing these infections is using nasal mupirocin plus chlorhexidine gluconate (CHG) bathing for ICU patients. This practice is known to prevent methicillin-resistant Staphylococcus aureus (MRSA) infections and all-cause. bloodstream infections. This practice has been broadly adopted in ICUs in the US, but adoption of mupirocin as a universal topical antibiotic has been slowed by concerns for engendering mupirocin resistance.
This cluster-randomized trial in adult ICUs was conducted to assess whether universal nasal antiseptic povidone-iodine (iodophor), to which minimal S. aureus resistance is expected, was an acceptable alternative to universal nasal mupirocin for reducing S. aureus and MRSA clinical cultures in the setting of daily CHG bathing. Those who received chlorhexidine (CHG) bathing with mupirocin had an 18% reduction in risk of Staphylococcus aureus clinical cultures and a 15% reduction in risk of methicillin-resistant S. aureus (MRSA) clinical cultures compared to patients who received CHG bathing with intranasal iodophor. These results show that using mupirocin for nasal decolonization may be preferred over iodophor because it is more effective at preventing S. aureus infections.
Dr. Jacob[/caption]
Jesse T. Jacob, MD
School of Medicine
Director, Antibiotic Stewardship Program
Emory University, Atlanta, Georgia
MedicalResearch.com: What is the background for this study?
Response: Since coronavirus disease 2019 (COVID-19) was recognized in the United States in January 2020, the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attributed to exposures in the health care workplace has been studied with conflicting results, and the role of job functions (such as nurse) or specific workplace activities, including care for individuals with known and unknown SARS-CoV-2 positivity, increase the risk of SARS-CoV-2 infection.
We assessed more than 24,000 healthcare providers between April and August 2020 across four large academic medical systems (Emory, Johns Hopkins, Rush University Medical Center, and University of Maryland) which collaborate in the CDC’s Prevention Epicenter Program and conduct innovative infection prevention research. Each site conducted voluntary COVID-19 antibody testing on its health care workers, as well as offered a questionnaire/survey on the employees’ occupational activities and possible exposures to individuals with COVID-19 infection both inside and outside the workplace. We also looked at three-digit residential zip-code prefixes to determine COVID-19 prevalence in communities.
Dr. Mahncke[/caption]
MedicalResearch.com: What is heart failure?
Response: Heart failure – sometimes called congestive heart failure or congestive cardiac failure – is when the heart cannot pump sufficient blood flow to maintain the body’s needs. Common symptoms include excessive tiredness, shortness of breath and swelling particularly in legs. It’s treated with a combination of lifestyle changes, drugs, and devices. An estimated 6.5 million Americans are diagnosed with heart failure, with 960,000 new cases each year, leading some to describe it as reaching epidemic proportions. In older adults, it’s the most common cause of hospital readmissions within 30 days of discharge and among the most costly areas of Medicare expenditures.
Dr. Johnson[/caption]
Dayna A. Johnson PhD
Department of Epidemiology
Emory University
Atlanta, GA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There are several studies that have determined that African Americans have the highest prevalence of hypertension and are the most likely to have uncontrolled hypertension compared to other racial/ethnic groups. We were interested in studying whether sleep apnea contributed to hypertension control among African Americans.
We found that participants with sleep apnea were more likely to have resistant hypertension than those without sleep apnea. In particular, individuals with severe sleep apnea had the highest risk of resistant hypertension. Most of the participants with measured sleep apnea were undiagnosed (96%).










