Long-term efficacy of a program to control methicillin-resistant Staphylococcus aureus.
The long-term efficacy of a program to control methicillin-resistant Staphylococcus aureus (MRSA) was evaluated in a 350-bed university hospital. Three periods were monitored: pre-epidemic (January 1989-November 1989), outbreak (December 1989-June 1990) and control program (July 1990-December 1992) periods. Control measures included cohort isolation, patient care measures and therapy (oral cotrimoxazole plus fusidic acid ointment) of MRSA carriage in patients, roommates and personnel. A total of 117 MRSA-infected patients were detected. For each period respectively, MRSA incidence (number of cases per 1,000 patient-days) was 3.2, 8.2 and 2.0 in the intensive care unit (ICU) and 0.08, 0.23 and 0.26 in the general wards. During the outbreak there was a 2.7-fold overall increase of baseline MRSA incidence (p < 0.02). The crude mortality was 68% and the attributable mortality was estimated to be 50%. The program was estimated to have prevented 76% (CI95 28-91, p < 0.0001) of expected MRSA cases and 85% (CI95 62-94, p < 0.0001) of expected fatalities due to MRSA in the ICU, but it had no significant effect in the general wards. The program did not control vancomycin consumption.
Valls
V
V
Servicio de Medicina Preventiva, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
Gómez-Herruz
P
P
González-Palacios
R
R
Cuadros
J A
JA
Romanyk
J P
JP
Ena
J
J
D002353:Carrier State / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D004196:Disease Outbreaks; D006801:Humans; D015994:Incidence; D017053:Infection Control; D007362:Intensive Care Units; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D013211:Staphylococcus aureus; D013997:Time Factors; D014640:Vancomycin / Q000008:administration & dosage
D014640:Vancomycin