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    Preventing MRSA Through Positive Deviance
    By Erin Richards | March 25th 2009 04:00 AM | 1 comment | Print | E-mail | Track Comments
    About Erin

    I am a current graduate student at USC Annenberg School for Communication and Journalism. I write for Neon Tommy, a digital news website, as a science...

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    One of the largest health threats facing our society today is not some super-virus spread from birds, or a tropical parasite spread by mosquito. Instead, it is the increasing resistance of common bacteria to antibiotics and even severe antibacterial treatment. Antibiotics have allowed us some amount of freedom from harmful bacterial infections, diseases and death, but as our antibiotics become overused, and ineffective against infection, our freedom from disease is significantly limited.

    In response to the growing problem of bacterial resistance, researchers have launched efforts to find new and better ways to defeat these uni-cellular pests, without the use of traditional antibiotics. A study conducted by The Robert Wood Johnson Foundation (RWJF) in conjunction with the Plexus Institute evaluated positive deviance, a novel prevention approach to change social behaviors, to lessen incidences of multifaceted methicillin-resistant Staphylococcus aureus (MRSA) infections in participating hospitals. Results of the study show that MRSA infections were dropped 26-62% in hospitals employing positive deviance.

    This photo shows MRSA bacteria, which is common in areas where people congregate and is easily transmissible. MRSA is resistant to most antibiotics and infections are difficult to treat. Photo credit: Baylor College of Medicine

    Staphylococcus is a common bacterium, and the resistant strain is often found in areas where there are a large number of people, and is common for people working or staying in hospitals to pick up an unwanted and hard to treat infection as a result. Results of this study are considerable due to the methods that focus on prevention as opposed to only treatment.

    "Reports of successful multicenter interventions to reduce endemic antimicrobial resistance problems among U.S. hospitals are extremely rare," says John A. Jernigan, MD, MS, an epidemiologist at the national Centers for Disease Control and Prevention (CDC). "These extremely encouraging findings add to a growing body of evidence that hospitals can make a difference in their endemic MRSA rates, and further might be able to improve the chances that infected patients have the best possible treatment options available. It shows that hospitals can make an important difference in antimicrobial resistance even at a time when the availability of new antibiotics has stagnated."
    The concept of Positive Deviance, brought about in 2006, is based upon beliefs that infections can be contained, and reduction of transmission can be greatly lowered through the diligence of hospital staff and others who could help control infections.

    Photo credit: Indiana University-Purdue University, Indianapolis

    Three hospitals participated in the Positive Deviance program and were evaluated by the CDC for effectiveness. The CDC analysis included screening patients for MRSA, isolation of infections, and rigorously adhering to strict measures for hand and contact hygiene.

    It is estimated that nearly 100,000 people develop invasive MRSA infections each year, resulting in approximately 19,000 deaths. Of these infections, about 86 percent are health care-associated.

    References:

    www.plexusinstitute.org.

    www.rwjf.org/pioneer.

    Comments

    Positive Deviance has been around since the 80's and was popularized after the work of Jerry and Monique Sternin in Vietnam in the 90's. It can be used for a lot of different problems - the idea being that it looks for solutions in the people facing the problem.