title: Eight years of decreased methicillin-resistant Staphylococcus aureus health care-associated infections associated with a Veterans Affairs prevention initiative.
abstract: Declines in methicillin-resistant Staphylococcus aureus (MRSA) health care associated infections (HAIs) were previously reported in Veterans Affairs acute care (2012), spinal cord injury (SCIU) (2011), and long-term-care facilities (LTCFs) (2012). Here we report continuing declines in infection rates in these settings through September 2015.
  
  
  
  Monthly data entered into a national database from 127 acute care facilities, 22 SCIUs, and 133 LTCFs were evaluated for trends using negative binomial regression.
  
  
  
  There were 23,153,240 intensive care unit (ICU) and non-ICU, and 1,794,234 SCIU patient-days from October 2007-September 2015, and 22,262,605 LTCF resident-days from July 2009-September 2015. Admission nasal swabbing remained >92% in all 3 venues. Admission prevalence changed from 13.2%-13.5% in acute care, from 35.1%-32.0% in SCIUs, and from 23.1%-25.0% in LTCFs during the analysis periods. Monthly HAI rates fell 87.0% in ICUs, 80.1% in non-ICUs, 80.9% in SCIUs, and 49.4% in LTCFs (all P values < .0001 for trend). During September 2015, there were 2 MRSA HAIs reported in ICUs, 20 (with 3 in SCIUs) in non-ICUs, and 31 in LTCFs nationwide.
  
  
  
  MRSA HAI rates declined significantly in acute care, SCIUs, and LTCFs over 8 years of the Veterans Affairs MRSA Prevention Initiative.
authors.affiliation: MRSA/MDRO Prevention Office, National Infectious Diseases Service, Patient Care Services, Veterans Health Administration, Washington, DC; Lexington Veterans Affairs Medical Center, Lexington, KY; Department of Internal Medicine, Division of Infectious Diseases, University of Kentucky School of Medicine, Lexington, KY. Electronic address: martin.evans@va.gov.
authors.forename: Martin E
authors.initials: ME
authors.lastname: Evans
authors.affiliation: National Infectious Diseases Service, Patient Care Services, Veterans Health Administration, Washington, DC; Cincinnati Veterans Affairs Medical Center, Cincinnati, OH; Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Kralovic
authors.affiliation: National Infectious Diseases Service, Patient Care Services, Veterans Health Administration, Washington, DC.
authors.forename: Loretta A
authors.initials: LA
authors.lastname: Simbartl
authors.affiliation: Patient Care Services, Veterans Health Administration, Washington, DC (retired).
authors.forename: Rajiv
authors.initials: R
authors.lastname: Jain
authors.affiliation: National Infectious Diseases Service, Patient Care Services, Veterans Health Administration, Washington, DC; Cincinnati Veterans Affairs Medical Center, Cincinnati, OH; Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Roselle
mesh_terms: D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D006787:Hospitals, Veterans; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D015995:Prevalence; D014481:United States / Q000453:epidemiology
keywords: Health care-associated transmission; Infection control; MRSA