Two-stage evaluation and intervention program for control of methicillin-resistant Staphylococcus aureus in the hospital setting.
The aim of this study was to develop a 2-stage evaluation and intervention program for control of methicillin-resistant Staphylococcus aureus (MRSA) in the hospital setting. The first stage included evaluation of MRSA prevalence throughout the entire hospital; the presence of MRSA was determined in patients or medical staff who had a high risk of carrying it (i.e. as a result of contact with surgical wounds). In the second stage, "contact isolation" (which included the use of gloves, hand washing before and after treatment of a patient and isolation of patients' personal belongings) was carried out in every patient from whom MRSA was isolated in 4 intervention departments-Surgery, Orthopaedics, General ICU and Neonatal ICU-while the same policy of attempting to isolate MRSA was maintained. Both stages lasted 7 months. A comparison between MRSA prevalence in the evaluation and intervention stages disclosed a decrease in MRSA isolates from 91 to 56 in the entire hospital (p = 0.2) and from 45 to 24 in the intervention departments (p = 0.05), respectively; while the number of patients with MRSA decreased from 87 to 55 in the entire hospital (p = 0.2) and from 45 to 18 in the intervention departments (p = 0.007). The number of patients treated with vancomycin decreased from 48 before intervention to 23 after "contact isolation" was started in the entire hospital (p = 0.02) and from 31 to 5 in the intervention departments (p = 0.001). These results provide additional evidence in favor of establishing a program to control MRSA spread.
Mishal
J
J
Department of Medicine B, Barzilai Medical Centre, Ashkelon, Israel.
Sherer
Y
Y
Levin
Y
Y
Katz
D
D
Embon
E
E
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control*; D006801:Humans; D008712:Methicillin / Q000627:therapeutic use; D016106:Methicillin Resistance; D010406:Penicillins / Q000627:therapeutic use; D015995:Prevalence; D015397:Program Evaluation; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014640:Vancomycin / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D010406:Penicillins; D014640:Vancomycin; D008712:Methicillin