Nationwide Safety Program associated with 65% reduction in hospital-onset MRSA bloodstream infections

Johns Hopkins Armstrong Institute researchers, federal partners and collaborators help hospitals translate evidence-based infection prevention strategies into everyday practice 

Johns Hopkins Medicine

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A large-scale, federally funded quality improvement program developed in collaboration with infection prevention experts at the Johns Hopkins Armstrong Institute for Patient Safety and Quality was associated with a 65% reduction in hospital-onset bloodstream infections caused by methicillin-resistant Staphylococcus aureus (MRSA) among participating hospital units.

The findings, published Aug. 27 in JAMA Network Open, suggest that a comprehensive approach to putting existing infection prevention evidence into everyday practice can substantially reduce infections among hospitalized patients. The Agency for Healthcare Research and Quality (AHRQ) Safety Program for MRSA Prevention was implemented in 106 intensive care units (ICUs) and 87 non-ICUs at 94 hospitals across the United States. The results highlight both the preventability of MRSA infections and the importance of a deliberate strategy for turning evidence into everyday practice.

“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,” says 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. “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.”

MRSA is a type of staph bacteria that is resistant to antibiotics, making infections more difficult to treat. Staph bacteria commonly live on human skin without causing illness, but hospitalized patients can be particularly vulnerable to infection because of underlying illnesses and invasive medical procedures. Devices such as central venous catheters provide lifesaving medications and fluids, but also cross the body’s natural skin barrier, creating a potential route for bacteria to enter the bloodstream.

To help prevent these infections, Johns Hopkins Armstrong Institute researchers and collaborators from NORC at the University of Chicago and AHRQ conducted an 18-month program centered on helping healthcare teams consistently implement a comprehensive set of infection prevention strategies targeting MRSA transmission and infection.

Participating hospital units received education and implementation resources on hand hygiene, environmental cleaning, device-associated infection prevention, chlorhexidine bathing and nasal decolonization. The program also engaged front-line workers across disciplines, including environmental services personnel.

“Taking the available evidence and implementing it is quite complex because you have to make sure that every front-line personnel member of the healthcare team is aware of the evidence and has the knowledge, skills and tools they need to implement it,” Maragakis says. “The system and workflow also have to support making sure those things happen every single time for every patient.”

Researchers compared infection rates during the 18-month implementation period with rates during the 12 months before the program began. Across participating ICUs and non-ICUs, the rate of hospital-onset MRSA bloodstream infections was 65% lower during the implementation period. Researchers also observed a 39% reduction in MRSA-positive clinical cultures collected later during hospitalization, a 37% reduction in bloodstream infections from all causes and a 31% reduction in central line-associated bloodstream infections.

The researchers also found changes in how participating units approached infection prevention. The proportion of ICUs reporting nasal MRSA decolonization for all patients increased from 35% to 61%, while the proportion of non-ICUs reporting the practice increased from 13% to 35%. Monitoring of environmental cleaning also increased from 50% to 75% among ICUs and from 52% to 76% among non-ICUs.

Collaboration among institutions helped make it possible to implement the program across hospitals nationwide, with researchers at NORC and AHRQ contributing to the coordination and infrastructure needed to support participating sites.

“It really was a large collaborative project,” Maragakis says. “Each researcher brought something different to the table, and that was important to making a project of this scale possible.”

The resulting AHRQ MRSA Prevention Toolkit is publicly available and includes educational and implementation materials that healthcare teams can use to build or strengthen infection prevention programs. Hospitals can select components based on the needs of an individual unit.

Researchers say many of the toolkit’s strategies address fundamental infection prevention practices that can help reduce the spread of other organisms and healthcare-associated infections as well.

“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,” Maragakis says. “There will be collateral benefits to doing these basics of infection prevention well beyond MRSA prevention.”

Other Johns Hopkins researchers who contributed to the study are Clare Rock, Valeria Fabre, Sara Cosgrove, Kathleen Speck, Samuel Kim, Kerri Huber, Cheryl Conners and Sandra Swoboda.

This work was funded and guided by the AHRQ (HHSP233201500020I/75P00120F37009).

COI: Maragakis reported receiving grants from the Agency for Healthcare Research and Quality (AHRQ) during the conduct of the study and serving as the president of the Society for Healthcare Epidemiology of America. Miller reported being an employee of AHRQ during the conduct of the study. Cosgrove reported receiving grants from AHRQ during the conduct of the study and personal fees from Danaher, Philips, and Duke Clinical Research Institute outside the submitted work. Kim reported that his salary from the Johns Hopkins University School of Medicine was supported in part by a contract between the school of medicine and AHRQ during the conduct of the study. Huber, Connors, Swoboda and Koepp reported receiving grants from AHRQ during the conduct of the study. No other disclosures were reported. 

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Journal

JAMA Network Open

 

Local industrial emissions linked to congressional election outcomes

Politicians’ environmental stances may influence industry and regulator action, with implications for the economy and public health in other districts, study finds

Penn State

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UNIVERSITY PARK, Pa. — The Clean Air Act of 1970 helped standardize pollution limits at the national level, but individual politicians can wield significant influence over the rates of industrial emissions in their districts, according to a new analysis conducted by a multi-institutional team that includes researchers at Penn State.  

Industrial plants located in districts represented by a narrowly elected Democrat have approximately 30% lower emissions on average than those located in districts that are narrowly won by a Republican, according to the researchers, who assessed nearly 40,000 industrial plants and more than 5,000 U.S. House elections over 25 years. They also found that firms with plants in multiple districts reallocated emissions away from areas represented by Democrats. This reallocation was associated with potential financial impacts for firms as well as public health concerns for local communities.  

The study was published in the September print edition of The Review of Financial Studies. 

“Firms have a lot more control over their emissions than we think,” said study co-author Stefan Lewellen, assistant professor of finance at Penn State’s Smeal College of Business. “This research suggests that even something as small as a local representative using some soft power to intervene causes those firms to turn up or turn down the pollution dial pretty significantly.” 

Industrial plants have several levers they can theoretically adjust to reduce their emissions, Lewellen said, including investing in abatement technologies like wet scrubbers — which remove pollutants directly from contaminated gas before release — increasing their postproduction treatment or simply lowering their production. Indeed, the researchers found a 47% higher investment in abatement technologies in Democratic districts as well as higher rates of postproduction treatment and recycling, though there were no major differences in plant productivity.  

The researchers examined data from 37,368 industrial plants and 5,304 U.S. House elections between 1991 and 2016, with their core analysis focused on a smaller subset of close elections. From these close elections, the researchers said they could isolate the impacts of a representative’s personal preferences from the pressures of voters in their district, since the overall environmental preferences of voters in a district should be largely similar regardless of the winning candidate’s party affiliation when the margin of victory is small. 

Congressional representatives typically do not wield much direct legislative influence over their districts, and most enforcement of Environmental Protection Agency regulations happens at the state and local levels — but politicians still hold power, the researchers said. 

“One of the things that's tricky about political soft power is that there's never going to be a smoking gun,” Lewellen said. “Politicians could be leaning on firms by going to state regulators and pushing for more inspections and tighter enforcement — or fewer inspections and less enforcement. You're never going to observe the phone call or the coffee meeting, so you have to look around the edges.” 

In addition, pollution permits are often more complicated than dictating a flat cap on emissions over the course of a year, Lewellen said. Pollution limits can be determined by the day, hour or even minute and can change based on a variety of factors like temperature, making inspections a key tool for regulators to catch irregularities in a system that otherwise offers some gray area for firms to overpollute.  

According to the team’s analysis, close Democratic wins were associated with around 34% higher inspections and roughly 30% more enforcement actions, most of which were informal actions like cease-and-desist letters as opposed to more severe formal actions like fines or investigations. 

“Companies really dislike being given enforcement fines because that tends to be very public and very negative publicity for the firm,” Lewellen explained, noting that firms will often comply and reduce emissions, but only enough to avoid harsher penalties. 

The researchers also found that emissions were higher at a plant when its parent firm’s other facilities were in districts with Democratic representation, suggesting that firms with plants in multiple districts reallocate emissions away from Democratic areas in an attempt to recoup their higher investment costs. 

However, this reallocation, the researchers note, was often imperfect. In fact, raising a firm’s share of Democratic representatives from zero to one also raised their cost of goods sold by about 4% and lowered their market-to-book ratio — a stock valuation metric that acts as a proxy for firm value — by a similar degree. 

Pulling data from the Center for Medicare and Medicaid Services, the researchers also explored how differing rates of pollution impacted public health within these districts. By breaking districts down into smaller areas based on three-digit ZIP codes — which correspond to metropolitan areas or regions within states that also act as typical service areas for hospitals — they compared respiratory illness rates and associated healthcare costs in areas with a high number of plants and those with a low number of plants. 

“Respiratory illnesses are always going to be higher in areas with lots of plants, but we can look to see whether that difference changes after, say, a Democrat is elected,” Lewellen said. “That way, we’re isolating the effects of the pollution from the other differences between the areas.” 

In areas with high numbers of plants, there was a 7% to 8% higher incidence of respiratory illnesses and 7% to 13% higher healthcare costs for respiratory-related hospital visits in districts represented by a Republican versus a Democrat, the researchers found. They estimated that each Democrat-to-Republican House seat transition is associated with 67 additional hospital visits costing around $628,000 per year.  

Lewellen said these results speak to a larger implication about the role of political representatives in the American democratic system. 

“Politicians' preferences are just as important as the laws that are passed in deciding what happens in their districts,” he said. 

A complete list of authors can be found in the paper.  

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Journal

Review of Financial Studies

DOI

10.1093/rfs/hhag039

Method of Research

Data/statistical analysis

Article Title

Smokestacks and the Swamp

Article Publication Date

1-Sep-2026

 

Scientists find microscopic evidence that magma repeatedly breaks and heals during eruptions

Tiny features preserved inside volcanic particles reveal that magma fragmentation occurs across different depths, temperatures, and stages of an eruption

Geological Society of America

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A gas and ash plume from Etna over the city of Catania, Italy, July 2026

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Credit: Photo Credit: Jacopo Taddeucci

Boulder, Colo., USA: Explosive volcanic eruptions can be as destructive as they are difficult to predict, launching pyroclasts—the fragments of magma and rock blasted from a volcano—into the air and surrounding areas. These particles can have wide-ranging impacts, as seen during this summer’s eruption of Mount Etna in Italy, when ash fell over the nearby city of Catania and closed its international airport for weeks. The size of erupted pyroclasts helps determine how far they travel and the hazards they pose. However, exactly how and where they form has remained poorly understood.

“They disrupt air traffic, they disrupt road traffic, and then you still have to remove them, and you still need to clean up and see their effect on crops, plants, vegetation in general, and wildlife,” says Jacopo Taddeucci, a volcanologist at Italy’s Istituto Nazionale di Geofisica e Vulcanologia. “It is important to understand how these particles are formed, because that controls their features.” 

A new study published in Geology, led by Taddeucci, shows that the fragmentation process that forms pyroclasts is more extensive than simplified eruption models often assume. Using scanning electron microscopy (SEM) and X-ray microtomography, the team analyzed pyroclasts from three mafic, or basaltic, volcanoes—Etna and Stromboli in Italy, and Cumbre Vieja in Spain—and linked their microscopic textures to formation conditions during different phases of eruption. 

By identifying and quantifying microtextures, including broken crystals, sutures, and incorporated clasts, Taddeucci and colleagues found that fragmentation occurs across several stages rather than at a single depth and moment. “This process is not occurring at a single point in space and time, but it’s protracted,” Taddeucci says. “It’s something that covers a span of time and a span of spaces that goes from inside the volcano to outside a volcano.”

Scientists had already observed multiple fragmentation events outside of volcanoes, including bombs and lapilli breaking apart in the air. This study provides the first microtextural evidence that fragmentation is also protracted inside a volcano, where it cannot be observed directly. 

The team also showed that crack healing and the welding together of pyroclasts can be just as important as fragmentation in controlling final particle size. “We are getting more and more evidence that not only the breaking of the magma controls the size of the particles, but also the fact that different particles can stick together after they are broken,” Taddeucci says. Because particle size influences how pyroclasts are dispersed, this finding could refine assumptions used in computer models of eruptions. 

When asked whether the same microtextures would appear in products from Etna’s eruption this summer, Taddeucci did not hesitate: “Oh, yes, of course,” he says. “Most basaltic eruptions that are explosive in nature will produce these kinds of features.” 

The microtextures can also be preserved in rocks from past eruptions, offering researchers a way to reconstruct earlier fragmentation conditions and improve models of future eruptions. “That’s a big advantage we have with respect to earthquakes or other disasters that don’t leave such a nice record,” Taddeucci says.

Taddeucci also emphasizes the collaborative nature of the work. Comparing eruptions across different volcanoes and countries, he notes, is only possible through collaboration with colleagues at observatories and institutions, including researchers beyond the paper’s official list of co-authors.

CITATION: Taddeucci, J., et al., 2026, Protracted magma fragmentation during mafic explosive eruptions: Geology, 27 July 2026, https://doi.org/10.1130/G54620.1

Sign up for e-Alerts for Geology, GSA Bulletin, and Geosphere current issues and pre-issue publications here. 

About the Geological Society of America

The Geological Society of America (GSA) is a global professional society with more than 18,000 members across over 100 countries. As a leading voice for the geosciences, GSA advances the understanding of Earth's dynamic processes and fosters collaboration among scientists, educators, and policymakers. GSA publishes Geology, the top-ranked geology journal, along with a diverse portfolio of scholarly journals, books, and conference proceedings—several of which rank among Amazon’s top 100 best-selling geology titles.

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Eruption plume from the basaltic Tajogaite eruption of the Cumbre Vieja volcano, Canady Islands, Spain

Credit

Photo Credit: Jacopo Taddeucci

Microtextures in a basaltic volcanic ash grain, showing broken crystal in an intact matrix and white suture lines where magma healed

Credit

Photo Credit: Jacopo Taddeucci

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Journal

Geology

DOI

10.1130/G54620.1

Article Title

Protracted magma fragmentation during mafic explosive eruptions

 

Only 1 out of every 5 amphibian type localities in Ecuador are in protected areas

The distribution of these sites is linked to the history of scientific samplings and accessibility

Universidad Tecnica Particular de Loja

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Chusquea Rain Frog (Pristimantis chusquea), a newly described endemic species from Abra de Zamora.

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Credit: Universidad Técnica Particular de Loja (UTPL)

In taxonomy, the location from which the specimens used to formally describe a new species are collected is called type locality. These sites can be thought of as the formal birthplace of the species, in the same way the scientific article containing the original description constitutes its scientific birth certificate, as this is how the species officially acquires its identity and name within the scientific community.

Of the 505 locations in Ecuador where amphibian species were first described, only 21% (i.e. 107) are located within the National System of Protected Areas, while 27% are in agricultural land and an additional 7% are in urbanized areas. This is the main finding of a study published in the journal Scientific Reports, which, for the first time, georeferenced and analyzed all these sites across the country.

The research team from the Universidad Técnica Particular de Loja gathered information on the 695 amphibian species recorded in the country to reconstruct where and when they were described; of these, 326 are known only from Ecuador. Of the total, 151 have an extremely restricted distribution, and 69 are known to occur only in their type locality and its surroundings.

The study found that type localities tend to be closer to roads and cities. While the initial phase of species description (up to 1950) focused on accessible areas, afterwards researchers expanded their samplings to higher altitudes and remote sites. As more regions have been explored, new species and type localities have continued to be discovered, revealing Ecuador's rich biodiversity. Furthermore, a complex relationship between the number of species described at a site and its diversity has been observed, primarily due to inaccessibility.

In Abra de Zamora and the city of Loja (within a 10x10 kilometre area), there is a concentration of type localities for 14 frog species, the highest number in the entire country; eight of the species are recorded only here. Of these, three species were collected in the 1930s by the Ecuadorian naturalist Clodoveo Carrión. With the expansion of urbanization, the populations of some of these amphibians have declined and have not been recorded again for decades.

The researchers also calculated that 34% of typical localities in Ecuador are in areas where land use is changing drastically due to human activities such as agriculture, urbanization, and deforestation.

The study shows that type localities can contribute to developing a new perspective for guiding conservation efforts, especially in sites that harbor microendemic species but also have high cultural and social value. The authors suggest that, in some cases, a viable way to protect these sites would be through the expansion of existing reserves, such as the Podocarpus National Park, to conserve biodiversity in the Abra de Zamora area, with which it shares a border.

 

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Journal

Scientific Reports

DOI

10.1038/s41598-026-53084-4

Method of Research

Data/statistical analysis

Subject of Research

Animals

Article Title

Patterns in the distribution of Ecuadorian amphibian type localities

Mosquito waste reveals viruses hiding in plain sight

A new approach to capture waste from mosquitoes could strengthen early warning systems for emerging health threats

Rutgers University

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Dana Price of the Rutgers Center for Vector Biology sets a mosquito-waste collection trap in the field as researchers work to adapt the approach for real-world surveillance.

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Credit: Dana Price/Rutgers University

When public health researchers want to know whether diseases such as COVID-19 or polio are circulating in a community, they can look for genetic evidence in wastewater.

Entomologist Dana Price wondered whether the same principle could be applied to mosquitoes. The question led to an unconventional experiment.

“What we did, colloquially, was build a mosquito toilet,” said Price, an associate professor at the Center for Vector Biology, Department of Entomology in the School of Environmental and Biological Sciences and a lead author of a study published in Microbiology Spectrum.

The device, Price said, is deceptively simple: a 3D-printed funnel coated with a superhydrophobic (water-repelling) material that causes liquid to bead up and slide into a collection tube.

The tiny traces of mosquito waste it captured revealed a hidden world.

By sequencing genetic material in mosquito excrement, Price recovered a complete West Nile virus genome, found the first known evidence of a Hedwig-like virus in the Americas and detected several viruses that may be new to science. The approach also identified parasites and confirmed the mosquito species that deposited the waste droplets.

Findings from the study suggest mosquito waste could become a powerful surveillance tool, allowing scientists to search broadly for familiar pathogens as well as threats they don’t yet know exist, Price said.

“If you don’t look for it, you won’t find it,” Price said. “But what if you don’t know what to look for?”

Mosquito surveillance historically involves collecting large numbers of insects, sorting them by species, combining them into pools and grinding them up for laboratory testing.

The labor-intensive process requires scientists to preserve the insects carefully, so their genetic material doesn’t degrade. During an outbreak, those steps can delay information needed to direct mosquito-control efforts. Conventional tests also target specific pathogens, so researchers must know what they are looking for.

Mosquitoes excrete small amounts of liquid containing genetic traces of viruses and other organisms. Because the waste contains far less mosquito tissue, and therefore less mosquito DNA, than a crushed insect, the scientists reasoned that viral material might be easier to find.

The researchers collected two groups of 50 wild Culex mosquitoes from a yard in New Brunswick, N.J., in 2021 and 2022. They placed each group in a screened container over the funnel and fed them a sugar solution. The mosquitoes produced drops of waste, which slid into a tube.

The scientists used shotgun metagenomic sequencing – used to sequence all genetic material present in a mixed sample. Computers then assembled the millions of fragments generated and compared them with known sequences in scientific databases.

The 2022 sample contained a complete, high-quality genome of West Nile virus, which can cause serious neurological illness in people.

The researchers identified the virus as belonging to the NY07 genetic variant previously found in the region. Such detail eventually could help scientists track how genetic variants of a virus emerge,spread and change.

“What came out was an entire viral genome,” Price said. “Rather than just positive or negative, we have genetic data.”

The researchers were even more intrigued by evidence of a Hedwig-like virus, which hadn’t previously been reported in the Americas.

Hedwig virus was first identified in Europe in snowy owl tissue, prompting scientists to name it after Harry Potter’s famous white owl. Some of the infected birds also hadWest Nile virus .

Scientists don’t know whether Hedwig-like viruses make birds sick, facilitate West Nile infections or simply coexist with other viruses. The Rutgers finding doesn’t establish that the virus is a threat, Price said. It shows that it has been circulating where no one knew to search for it.

“We didn’t even look for it specifically,” Price said. “We just looked for everything, and we found Hedwig in there.”

He currently is working with officials at the New Jersey Department of Environmental Protection’s Division of Fish and Wildlife to screen organ and tissue samples for the virus. The samples are collected from deceased birds during a post-mortem examination.

A virus found for the first time in a region may have recently arrived or may have gone unnoticed for years. Because few broad mosquito-virus studies have been conducted in North America, organisms that seem geographically restricted may prove widespread.

“The more data we generate, the more we start to wonder if everything is everywhere,” Price said. “Although we don’t yet know how much of everything is everywhere, it may be a lot more than we realize.”

The samples also contained sequences so different from known examples that the researchers classified the viruses as potentially new. They included a partiti-like virus, a picorna-like virus and a possible new virus associated with single-celled parasites infecting the mosquitoes. More study is needed to confirm they are previously undescribed species.

Most appear to infect mosquitoes, other insects or microorganisms living inside mosquitoes and are not known to cause human disease. Some insect-specific viruses may even interfere with mosquitoes’ ability to carry West Nile, dengue or Zika viruses.

The waste also contained traces of trypanosomatids, a group of single-celled parasites known to infect mosquitoes. Mosquito DNA confirmed that the insects belonged primarily to the Culex pipiens group, a West Nile carrier.

Price said the research was an initial demonstration, not a replacement for existing surveillance. It examined 100 mosquitoes from one location, which were transferred to the funnel in a laboratory.

Researchers also cannot conclude from waste alone that a mosquito can transmit a virus, Price said. It could be infecting the mosquito or another organism inside it or simply passing through.

For now, the technique can answer a broader question: Is a pathogen circulating in this environment?

The team is working toward a field-ready trap that would collect mosquitoes and their waste. Price eventually envisions a system that could prepare samples, sequence genetic material, analyze the results remotely and alert scientists to a possible threat in real-time.

“The pie-in-the-sky idea is a device that we place in a forest somewhere, and it’s constantly just beaming back data to us,” Price said.

Such a system could be especially valuable in remote or resource-limited areas, he said. It could reveal known pathogens before they cause widespread illness and expose the ones no one yet knows to look for.

Other Rutgers researchers on the study include: Mehdi Javanmard from the Department of Electrical and Computer Engineering in the Rutgers School of Engineering; Taewon Han, an assistant research professor from the Department of Environmental Sciences in the School of Environmental and Biological Sciences; Nicole Wagner, a laboratory researcher; and former undergraduate students Miranda Barnes and Fiona Bezhani.

Explore more of the ways Rutgers research is shaping the future.

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Journal

Microbiology Spectrum

DOI

10.1128/spectrum.00938-26

Method of Research

Data/statistical analysis

Subject of Research

Animal tissue samples

Article Title

Metaviromic profiling of mosquito excreta using superhydrophobic collection devices expands the known RNA virome of North America

Rutgers entomologist Dana Price holds a tube containing mosquito waste collected for genetic analysis. 

Credit

Dana Price/Rutgers University