title: Impact of a mandatory infection control education program on nosocomial acquisition of methicillin-resistant Staphylococcus aureus.
abstract: 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.
authors.affiliation: University of Toronto, Canada.
authors.forename: Todd C
authors.initials: TC
authors.lastname: Lee
authors.forename: Christine
authors.initials: C
authors.lastname: Moore
authors.forename: Janet M
authors.initials: JM
authors.lastname: Raboud
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Muller
authors.forename: Karen
authors.initials: K
authors.lastname: Green
authors.forename: Agnes
authors.initials: A
authors.lastname: Tong
authors.forename: Jastej
authors.initials: J
authors.lastname: Dhaliwal
authors.forename: Allison
authors.initials: A
authors.lastname: McGeer
mesh_terms: 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