title: Use of a temporary cohort ward as part of an intervention to reduce the incidence of meticillin-resistant Staphylococcus aureus in a vascular surgery ward.
abstract: This article describes the effect of introducing a cohort area into a vascular surgery ward where a sustained increase in new cases of meticillin-resistant Staphylococcus aureus (MRSA) made the implementation of standard MRSA infection control precautions untenable. A recent review of published reports concluded, 'that little evidence could be found to suggest that isolation measures recommended in the UK are effective'. The authors recommended a reporting format to enable the evidence for isolation to be gathered more systematically. This paper follows the recommended reporting format. The setting was a 30-bedded acute and subacute vascular surgery ward within a tertiary care hospital in Glasgow, UK. The data were analysed as an interrupted time series of 19 months pre-cohort, eight months with cohort and eight months post cohort. Following the instigation of the cohort area, there was a significant reduction in the number of nosocomial MRSA isolates from patients (P=0.0005). This reduction was sustained after the cohort area was discontinued. In conclusion, effective separation of MRSA-colonized/-infected patients from patients who are not colonized/infected with MRSA, using a cohort area, resulted in a significant reduction in MRSA cross-colonization and cross-infection. The resulting reduction in MRSA prevalence within the unit facilitated effective screening and isolation of subsequent patients once the cohort area had been discontinued.
authors.affiliation: North Glasgow University Hospitals Division, Glasgow, UK. evonne@northglasgow.scot.nhs.uk
authors.forename: E T
authors.initials: ET
authors.lastname: Curran
authors.forename: K
authors.initials: K
authors.lastname: Hamilton
authors.forename: A
authors.initials: A
authors.lastname: Monaghan
authors.forename: M
authors.initials: M
authors.lastname: McGinlay
authors.forename: B
authors.initials: B
authors.lastname: Thakker
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D004197:Disease Reservoirs / Q000382:microbiology; D004739:England; D006801:Humans; D017053:Infection Control / Q000379:methods*; D016106:Methicillin Resistance; D010356:Patient Isolation / Q000379:methods*; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013503:Surgery Department, Hospital