title: Trend of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in an institution with a high rate of MRSA after the reinforcement of antibiotic stewardship and hand hygiene.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) infections are a concern across the worldwide.
  
  
  METHODS
  Antibiotic stewardship and hand hygiene programs were reinforced in a 2,000-bed tertiary hospital in South Korea where the methicillin resistance rate of Staphylococcus aureus is about 65%. The computerized prescription restriction was implemented in August 2008. "Hand hygiene program," consistent with World Health Organization guideline, was reinforced in December 2008. We assessed the effect of the infection control programs on the incidence of MRSA bloodstream infection (BSI) from January 2006 through November 2011.
  
  
  RESULTS
  Incidence of MRSA BSI was reduced from 0.171 per 1,000 patient-days in 2009 to 0.116 per 1,000 patient-days in 2011 (P = .009). Monthly mean antibiotic consumption decreased from 690.54 ± 28.33 defined daily dose per 1,000 patients-days in 2008 to 652.47 ± 20.77 (P = .015) in 2011. The rates of performance in hand hygiene increased from 43% in 2008 to 83% in 2011 (P = .043).
  
  
  CONCLUSIONS
  Although we did not implement all components of "MRSA bundle," efforts to reinforce antibiotic stewardship and hand hygiene program for 3 years had beneficial effects on the decrease in MRSA BSI in this institute with high rate of MRSA.
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Kim
authors.forename: Min Hyung
authors.initials: MH
authors.lastname: Kim
authors.forename: Je Eun
authors.initials: JE
authors.lastname: Song
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Ahn
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Oh
authors.forename: Oh Mee
authors.initials: OM
authors.lastname: Kweon
authors.forename: Dongsuk
authors.initials: D
authors.lastname: Lee
authors.forename: Sun Bean
authors.initials: SB
authors.lastname: Kim
authors.forename: Hye-won
authors.initials: HW
authors.lastname: Kim
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Jeong
authors.forename: Nam Su
authors.initials: NS
authors.lastname: Ku
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Han
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Park
authors.forename: Dongeun
authors.initials: D
authors.lastname: Yong
authors.forename: Young Goo
authors.initials: YG
authors.lastname: Song
authors.forename: Kyungwon
authors.initials: K
authors.lastname: Lee
authors.forename: June Myung
authors.initials: JM
authors.lastname: Kim
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Choi
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control; D004363:Drug Utilization; D005260:Female; D006235:Hand Disinfection; D063373:Hand Hygiene; D006801:Humans; D057970:Inappropriate Prescribing; D015994:Incidence; D017053:Infection Control / Q000592:standards; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents