title: [Evaluation of the efficacy of a program to control nosocomial spread of methicillin-resistant Staphylococcus aureus].
abstract: 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.
authors.affiliation: Istituti Ospitalieri di Cremona, Brescia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pan
authors.forename: P
authors.initials: P
authors.lastname: Catenazzi
authors.forename: L
authors.initials: L
authors.lastname: Ferrari
authors.forename: C
authors.initials: C
authors.lastname: Tinelli
authors.forename: E
authors.initials: E
authors.lastname: Seminari
authors.forename: A
authors.initials: A
authors.lastname: Ratti
authors.forename: G
authors.initials: G
authors.lastname: Carnevale
authors.forename: A
authors.initials: A
authors.lastname: Cogrossi
authors.forename: L
authors.initials: L
authors.lastname: Crema
authors.forename: L
authors.initials: L
authors.lastname: Dolcetti
authors.forename: C
authors.initials: C
authors.lastname: Barosi
authors.forename: L
authors.initials: L
authors.lastname: Granata
authors.forename: A
authors.initials: A
authors.lastname: La Russa
authors.forename: N
authors.initials: N
authors.lastname: Poli
authors.forename: D
authors.initials: D
authors.lastname: Tomasoni
authors.forename: T
authors.initials: T
authors.lastname: Ceruti
mesh_terms: 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