title: Controlling methicillin-resistant Staphylococcus aureus (MRSA) in a hospital and the role of hydrogen peroxide decontamination: an interrupted time series analysis.
abstract: OBJECTIVE
  The impact of surface disinfection versus detergent cleaning on healthcare associated infection rates remains unresolved. We aimed to evaluate the efficacy of hydrogen peroxide (HP) decontamination against methicillin-resistant Staphylococcus aureus (MRSA).
  
  
  METHODS
  Single centred retrospective before and after study design.
  
  
  METHODS
  Launceston General Hospital, Tasmania, Australia.
  
  
  METHODS
  Patients with MRSA infection or colonisation.
  
  
  METHODS
  Rooms occupied by patients with MRSA infection or colonisation were cleaned following discharge with either detergent or HP.
  
  
  METHODS
  MRSA room contamination following cleaning; new MRSA acquisition in patients.
  
  
  RESULTS
  Over 3600 discharge cleans were completed, with more than 32 600 environmental swabs processed. MRSA was isolated from 24.7% rooms following detergent cleaning and from 18.8% of rooms after HP (p<0.001). The incidence of MRSA acquisition reduced from 9.0 to 5.3 per 10 000 patient days in detergent and disinfectant arms, respectively (p<0.001).
  
  
  CONCLUSIONS
  Use of HP disinfection led to a decrease in residual MRSA contamination in patient rooms compared with detergent. It may also have encouraged the reduction in patient MRSA acquisition despite several confounders including staff feedback on terminal cleaning, additional MRSA screening and quicker laboratory methods. Infection control is best served by concurrent interventions targeting both the patient and healthcare environment.
authors.affiliation: Faculty of Nursing and Health, Avondale College of Higher Education, New South Wales, Australia.
authors.forename: Brett G
authors.initials: BG
authors.lastname: Mitchell
authors.forename: Wilhelmine
authors.initials: W
authors.lastname: Digney
authors.forename: Phil
authors.initials: P
authors.lastname: Locket
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Dancer
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods*; D006779:Hospitals, Public; D006801:Humans; D006861:Hydrogen Peroxide / Q000494:pharmacology*; D017053:Infection Control / Q000379:methods*; D065186:Interrupted Time Series Analysis; D055624:Methicillin-Resistant Staphylococcus aureus; D010362:Patients' Rooms; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D013648:Tasmania / Q000453:epidemiology
chemical_list: D006861:Hydrogen Peroxide
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