Impact of active surveillance and contact isolation on transmission of methicillin-resistant Staphylococcus aureus in intensive care units in an area with high prevalence.
OBJECTIVE
Previous research has suggested that active surveillance and early initiation of contact isolation (ASI) can control the nosocomial spread of methicillin-resistant Staphylococcus aureus (MRSA), especially among intensive care unit (ICU) patients. However, these interventions have never been implemented in Taiwan.


METHODS
This study was conducted from September 2005 to October 2006 to evaluate the effect of ASI on the spread of MRSA in two medical centers in Taiwan with a high prevalence of MRSA. One ICU from each hospital was selected as a study site. In phase I (the first 6 months), only active surveillance was introduced. In phase II (the final 6 months), ASI for patients who had positive MRSA cultures was implemented.


RESULTS
The incidence of acquiring MRSA during ICU stay did not differ significantly during phases I and II in hospital A (p = 0.940) and hospital B (p = 0.810). The independent risk factors for acquiring MRSA in the ICU were length of stay and presence of respiratory tract diseases.


CONCLUSIONS
This study demonstrated that, given the current resource limitations, ASI alone could not reduce MRSA transmission in two ICUs in Taiwan, where the MRSA prevalence was high.
Wang
Jann-Tay
JT
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Lauderdale
Tsai-Ling
TL
Lee
Wen-Sen
WS
Huang
Jeng-Hua
JH
Wang
Tsung-Hsi
TH
Chang
Shan-Chwen
SC
D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods; D007362:Intensive Care Units; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D015397:Program Evaluation; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission*; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors