title: Molecular epidemiology and control of nosocomial methicillin-resistant Staphylococcus aureus infection in a teaching hospital.
abstract: OBJECTIVE
  Nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection is difficult to control. Due to a dramatic increase in the nosocomial MRSA infection rate at our hospital from 2000 to 2001, this study was conducted to identify the source of these infections and the effectiveness of control measures.
  
  
  METHODS
  179 healthcare workers (HCWs) were screened for carriage of MRSA. Starting in April 2001, all patients with MRSA infection or colonization were put in strict contact and cohort isolation. The bacterial isolates of HCW carriers and patients with MRSA infection from April 2001 to September 2001 were subjected to antimicrobial susceptibility testing by disk-diffusion method and molecular typing by pulsed-field gel electrophoresis (PFGE).
  
  
  RESULTS
  Fifteen HCWs were found to be carriers of MRSA. They were all given topical mupirocin treatment. After these interventions, the nosocomial MRSA infection rate decreased from 1.23 to 0.53 per 1000 patient-days. All 61 MRSA isolates available for antimicrobial susceptibility testing and molecular typing were multidrug resistant. PFGE study revealed 2 predominant types, type C and type Y, comprising 36 and 12 isolates, respectively.
  
  
  CONCLUSIONS
  The current study demonstrates the importance of measures to control nosocomial MRSA infections in hospitals that already have a high incidence of endemic MRSA infection. Elimination of carriage by healthcare workers, and strict contact and cohort isolation are the main effective measures.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jann-Tay
authors.initials: JT
authors.lastname: Wang
authors.forename: Sheng-Fong
authors.initials: SF
authors.lastname: Lin
authors.forename: Hsu-Ling
authors.initials: HL
authors.lastname: Chiu
authors.forename: Li-Chen
authors.initials: LC
authors.lastname: Wang
authors.forename: Hui-Ming
authors.initials: HM
authors.lastname: Tai
authors.forename: Chaw-Fung
authors.initials: CF
authors.lastname: Jiang
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
authors.forename: Shu-Hsun
authors.initials: SH
authors.lastname: Chu
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D006784:Hospitals, Teaching; D006801:Humans; D017053:Infection Control / Q000379:methods; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control*; D016106:Methicillin Resistance; D016712:Mupirocin / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D013211:Staphylococcus aureus; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin