Impact of a mandatory infection control education program on nosocomial acquisition of methicillin-resistant Staphylococcus aureus.
OBJECTIVE
To assess the impact of an institution-wide infection control education program on the rate of transmission of methicillin-resistant Staphylococcus aureus (MRSA).


METHODS
Before-and-after study.


METHODS
A 472-bed, urban, university-affiliated hospital.Intervention. During the period March-May 2004, all hospital staff completed a mandatory infection control education program, including the receipt of hospital-specific MRSA data and case-based practice with additional precautions.


METHODS
The rate of nosocomial MRSA acquisition was calculated as the number of cases of nosocomial MRSA acquisition per 100 days that a person with MRSA colonization or infection detected at admission is present in the hospital ("admission MRSA" exposure-days) for 3 time periods: June 2002-February 2003 (before the Toronto outbreak of severe acute respiratory syndrome [SARS]), June 2003-February 2004 (after the outbreak of SARS), and June 2004-February 2005 (after education). A case of nosocomial acquisition of MRSA colonization or infection represented a patient first identified as colonized or infected more than 72 hours after admission or at admission after a previous hospitalization.


RESULTS
The rate of nosocomial acquisition of MRSA colonization or infection was 8.8 cases per 100 admission MRSA exposure-days for the period before SARS, 3.8 cases per 100 admission MRSA exposure-days for the period after SARS (P<.001 for before SARS vs after SARS), and 1.9 cases per 100 admission MRSA exposure-days for the period after education (P=.02 for after education vs before education). The volume of alcohol-based handrub purchased was apparently stable, with 4,010 L during fiscal year 2003-2004 (April 2003-March 2004) compared with 3,780 L during fiscal year 2004-2005. The observed rate of compliance with hand washing did not change significantly (40.9% during education vs 44.2% after education; P=.23). The total number of patients screened for MRSA colonization was not different in the 3 periods.


CONCLUSIONS
The rate of nosocomial acquisition of MRSA colonization or infection decreased after SARS and was further reduced in association with a hospital-wide education program.
Lee
Todd C
TC
University of Toronto, Canada.
Moore
Christine
C
Raboud
Janet M
JM
Muller
Matthew P
MP
Green
Karen
K
Tong
Agnes
A
Dhaliwal
Jastej
J
McGeer
Allison
A
D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006266:Health Education / Q000592:standards*; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000592:standards*; D037141:Mandatory Programs / Q000706:statistics & numerical data*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D015397:Program Evaluation; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology / Q000635:transmission; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission