Hospital Safety Program Linked to 65% Reduction in MRSA Bloodstream Infections

Vulnerability rises in hospitalized populations because invasive devices and procedures breach skin barriers. Preventing transmission and device-associated infection remains operationally challenging for multidisciplinary teams. To help address this challenge, a nationwide safety program was developed to translate established infection prevention evidence into consistent bedside practice.

The Agency for Healthcare Research and Quality (AHRQ; Rockville, MD, USA) Safety Program for MRSA Prevention was created with infection prevention experts at the Johns Hopkins Armstrong Institute for Patient Safety and Quality, in collaboration with NORC at the University of Chicago and AHRQ. The program was implemented across 94 U.S. hospitals in 106 intensive care units (ICUs) and 87 non-ICUs. Its aim was to standardize and sustain practices that interrupt MRSA transmission and reduce bloodstream infections.

The program provided education and implementation resources on hand hygiene, environmental cleaning, device-associated infection prevention, chlorhexidine bathing, and nasal decolonization. Teams engaged front-line staff across disciplines, including environmental services, to embed practices within daily workflows. The approach emphasized deliberate implementation strategies so that prevention steps occurred reliably for every patient.

Investigators compared outcomes during an 18‑month implementation period with the 12 months preceding program launch. Hospital-onset MRSA bloodstream infection rates were 65% lower during implementation across participating ICUs and non-ICUs. The findings were published on August 27, 2026, in JAMA Network Open.

Additional benefits were observed beyond MRSA bloodstream infections. MRSA-positive clinical cultures collected later in hospitalization fell by 39%. Bloodstream infections from all causes declined by 37%, and central line–associated bloodstream infections decreased by 31%. Practice adoption increased during the program, with nasal MRSA decolonization reported for all patients rising from 35% to 61% in ICUs and from 13% to 35% in non-ICUs. Monitoring of environmental cleaning increased from 50% to 75% among ICUs and from 52% to 76% among non-ICUs.

Resources developed through the effort are available in the AHRQ MRSA Prevention Toolkit, which hospitals can tailor to unit needs. The researchers noted that many components address fundamental practices applicable to other healthcare-associated infections and organism transmission.

“Some people think risks from multidrug-resistant organisms like MRSA are inevitable, that they’re not preventable, but we in infection prevention know that they are. Infection prevention works, but it is complex. It takes a very deliberate implementation strategy to translate the existing evidence into practice so we can protect patients,” said Lisa Maragakis, M.D., M.P.H., senior author of the study, professor of medicine and epidemiology at the Johns Hopkins University School of Medicine, and Armstrong Institute for Patient Safety and Quality faculty.

“This toolkit is about MRSA prevention, but once you get into it, you’ll see it’s really about preventing healthcare-associated infections and organism transmission. There will be collateral benefits to doing these basics of infection prevention well beyond MRSA prevention,” added Maragakis.

Related Links
AHRQ
Johns Hopkins Armstrong Institute for Patient Safety and Quality
NORC at the University of Chicago