title: Implementation of a methicillin-resistant Staphylococcus aureus (MRSA) prevention bundle results in decreased MRSA surgical site infections.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) surgical site infections (SSIs) increase morbidity and mortality. We examined the impact of the MRSA bundle on SSIs.
  
  
  METHODS
  Data regarding the implementation of the MRSA bundle from 2007 to 2008 were obtained, including admission and discharge MRSA screenings, overall MRSA infections, and cardiac and orthopedic SSIs. Chi-square was used for all comparisons.
  
  
  RESULTS
  A significant decrease in MRSA transmission from a 5.8 to 3.0 per 1,000 bed-days (P < .05) was found after implementation of the MRSA bundle. Overall MRSA nosocomial infections decreased from 2.0 to 1.0 per 1,000 bed-days (P = .016). There was a statistically significant decrease in overall SSIs (P < .05), with a 65% decrease in orthopaedic MRSA SSIs and 1% decrease in cardiac MRSA SSIs.
  
  
  CONCLUSIONS
  Our data demonstrate that successful implementation of the MRSA bundle significantly decreases MRSA transmission between patients, the overall number of nosocomial MRSA infections, and MRSA SSIs.
authors.affiliation: Michael E DeBakey Department of Surgery, Baylor College of Medicine, and Michael E DeBakey Veterans Affairs Hospital, Houston, TX, USA. sawad@bcm.tmc.edu
authors.forename: Samir S
authors.initials: SS
authors.lastname: Awad
authors.forename: Carlos H
authors.initials: CH
authors.lastname: Palacio
authors.forename: Anuradha
authors.initials: A
authors.lastname: Subramanian
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Byers
authors.forename: Paula
authors.initials: P
authors.lastname: Abraham
authors.forename: Debra A
authors.initials: DA
authors.lastname: Lewis
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Young
mesh_terms: D006348:Cardiac Surgical Procedures; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008403:Mass Screening / Q000458:organization & administration; D055624:Methicillin-Resistant Staphylococcus aureus; D019637:Orthopedic Procedures; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D015995:Prevalence; D016730:Program Development; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control*; D013781:Texas / Q000453:epidemiology