[Evaluation of the efficacy of a program to control nosocomial spread of methicillin-resistant Staphylococcus aureus].
OBJECTIVE
To evaluate the efficacy of a program to control nosocomial spread of methicillin-resistant Staphylococcus aureus (MRSA).


METHODS
Analysis of the incidence of infection and contamination due to MRSA in patients admitted to the hospital of Cremona 6 months before and 3 years after the introduction of the guidelines (July 1997).


RESULTS
During the 42 months of the study period, on 80705 admissions, 511 cases of MRSA contamination/infection were identified, the incidence being 0.57 cases per 100 admissions. The infection rate dropped from 0.34 (IC95%: 0.25-0.45) in the first 6 months of the study, before the introduction of guidelines, to 0.17 (IC95%: 0.14-0.20) in the following 3 years (p=0.01). Severe infection decreased from 0.18 to 0.1 per 100 admissions, with a 44% decrease (p=0.058), while mild infections diminished from 0.16 to 0.07 per 100 admissions (p=0.045). Methicillin resistance among nosocomial isolates of Staphylococcus aureus was reduced from 53 % to 35 % (p<0.0001).


CONCLUSIONS
The introduction of a program to control the nosocomial spread of MRSA proved effective in reducing both the incidence of infection and the methicillin-resistance of Staphylococcus aureus isolates. The cost effectiveness of the program seems very favourable.
Pan
A
A
Istituti Ospitalieri di Cremona, Brescia, Italy.
Catenazzi
P
P
Ferrari
L
L
Tinelli
C
C
Seminari
E
E
Ratti
A
A
Carnevale
G
G
Cogrossi
A
A
Crema
L
L
Dolcetti
L
L
Barosi
C
C
Granata
L
L
La Russa
A
A
Poli
N
N
Tomasoni
D
D
Ceruti
T
T
D001826:Body Fluids / Q000382:microbiology; D002353:Carrier State / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D003955:Diagnostic Tests, Routine; D006786:Hospitals, Urban / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D007558:Italy / Q000453:epidemiology; D016106:Methicillin Resistance; D010356:Patient Isolation; D010362:Patients' Rooms; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D012307:Risk Factors; D012621:Seasons; D013048:Specimen Handling; D013203:Staphylococcal Infections / Q000191:economics / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification