title: Comparison of control strategies for methicillin-resistant Staphylococcus aureus.
abstract: BACKGROUND
  Screening patients for methicillin-resistant Staphylococcus aureus (MRSA) colonization and contact precautions for colonized patients has been recommended when other control measures have been ineffective.
  
  
  METHODS
  We compared MRSA transmission rates following implementation of a bundle of control measures that included institutional culture change, surveillance for MRSA infection and transmission, and active screening for colonization in 2 similar Veterans Health Administration hospitals. One hospital employed contact precautions as defined by the Centers for Disease Control and Prevention, and the other hospital modified contact precautions, requiring only the use of gloves.
  
  
  RESULTS
  During the 4-year study period, there were 1.58 MRSA transmissions per 1,000 patient-days at hospital A and 1.56 MRSA transmissions per 1,000 patient-days at hospital B (P = .98). Both hospitals experienced significant reductions in MRSA health care-associated infections (HAI). There was no difference between hospital A and hospital B in incidence of MRSA HAIs or MRSA surgical site infections. Annual acquisition costs for cover gowns were $183,609 at hospital A and $25,812 at hospital B.
  
  
  CONCLUSIONS
  Significant reductions in MRSA HAI were associated with implementation of the MRSA control bundle. The bundle that included full contact precautions for colonized patients was no more effective in prevention of MRSA transmissions than a similar bundle that omitted the use of cover gowns.
authors.affiliation: Department of Veterans Affairs Eastern Colorado Healthcare System, Department of Medicine, University of Colorado-Denver, Denver, CO. Electronic address: Mary.Bessesen@va.gov.
authors.forename: Mary T
authors.initials: MT
authors.lastname: Bessesen
authors.forename: Karla
authors.initials: K
authors.lastname: Lopez
authors.forename: Karen
authors.initials: K
authors.lastname: Guerin
authors.forename: Karen
authors.initials: K
authors.lastname: Hendrickson
authors.forename: Shavetta
authors.initials: S
authors.lastname: Williams
authors.forename: Susan
authors.initials: S
authors.lastname: O'Connor-Wright
authors.forename: Donald
authors.initials: D
authors.lastname: Granger
authors.forename: Maureen
authors.initials: M
authors.lastname: Bunch
mesh_terms: D000368:Aged; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*
keywords: Carrier state; Cross infection; Infection control; Multidrug-resistant organism; Patient isolation