Strategies to Prevent Hospital-onset Staphylococcus aureus Bloodstream Infections in Acute Care Facilities

Introduction

Purpose:

This document provides information about interventions for prevention of hospital-onset Staphylococcus aureus Bloodstream Infections (HO SA BSIs) in acute care facilities. The strategies are intended to facilitate implementation of HO SA BSI prevention efforts by state and local health departments, quality improvement organizations, hospital associations, and healthcare facilities. The interventions are not intended for use in response to an outbreak.

All acute care facilities should reinforce core infection control practices on an ongoing basis. This includes ongoing competency-based training and monitoring adherence with feedback of results for hand hygiene, environmental cleaning and disinfection, and use of personal protective equipment. Hospitals should work to implement the CDC Core Elements of Hospital Antibiotic Stewardship Programs

Core and supplemental strategies for prevention of HO SA BSIs in acute care facilities are listed below. Core strategies are strongly supported by published evidence and should form the foundation of HO SA BSI prevention. Supplemental strategies are generally supported by less evidence and should be considered for use when reduction goals are not met after implementation of core interventions or when facilities wish to implement a more aggressive prevention strategy.

To develop a HO SA BSI prevention strategy, facilities should first review recent episodes of HO SA BSI to identify common risk factors and underlying syndromes that might help identify the populations and interventions which might be most important to target. Elements that should be reviewed include associated syndromes (e.g., wound infections or pneumonia) that may have led to the BSI, unit types, presence of indwelling devices such as central venous catheters (CVCs), and prior invasive procedures or surgeries. Based on this review of facility-level data, each facility should select core and supplemental strategies for implementation that are most likely to have an impact on facility rates.