RT Journal Article
T1 Long-Term Control of Endemic Hospital-Wide Methicillin-Resistant Staphylococcus aureus (MRSA): The Impact of Targeted Active Surveillance for MRSA in Patients and Healthcare Workers
A1 Rodríguez-Baño, Jesús
A1 García, Lola
A1 Ramírez, Encarnación
A1 Lupión, Carmen
A1 Muniain, Miguel A.
A1 Velasco, Carmen
A1 Gálvez, Juan
A1 del Toro, M. Dolores
A1 Millán, Antonio B.
A1 López-Cerero, Lorena
A1 Pascual, Álvaro
K1 Methicillin-Resistant Staphylococcus aureus
K1 Patients
K1 Workers
K1 Staphylococcus aureus Resistente a Meticilina
K1 Pacientes
K1 Trabajadores
AB To evaluate the long-term impact of successive interventions on rates of methicillin-resistant Staphylococcus aureus (MRSA) colonization or infection and MRSA bacteremia in an endemic hospital-wide situation. DESIGN:Quasi-experimental, interrupted time-series analysis. The impact of the interventions was analyzed by use of segmented regression. Representative MRSA isolates were typed by use of pulsed-field gel electrophoresis. SETTING:A 950-bed teaching hospital in Seville, Spain.PATIENTS:All patients admitted to the hospital during the period from 1995 through 2008. METHODS:Three successive interventions were studied: (1) contact precautions, with no active surveillance for MRSA; (2) targeted active surveillance for MRSA in patients and healthcare workers in specific wards, prioritized according to clinical epidemiology data; and (3) targeted active surveillance for MRSA in patients admitted from other medical centers. RESULTS:Neither the preintervention rate of MRSA colonization or infection (0.56 cases per 1,000 patient-days [95% confidence interval {CI}, 0.49-0.62 cases per 1,000 patient-days]) nor the slope for the rate of MRSA colonization or infection changed significantly after the first intervention. The rate decreased significantly to 0.28 cases per 1,000 patient-days (95% CI, 0.17-0.40 cases per 1,000 patient-days) after the second intervention and to 0.07 cases per 1,000 patient-days (95% CI, 0.06-0.08 cases per 1,000 patient-days) after the third intervention, and the rate remained at a similar level for 8 years. The MRSA bacteremia rate decreased by 80%, whereas the rate of bacteremia due to methicillin-susceptible S. aureus did not change. Eighty-three percent of the MRSA isolates identified were clonally related. All MRSA isolates obtained from healthcare workers were clonally related to those recovered from patients who were in their care. CONCLUSION:Our data indicate that long-term control of endemic MRSA is feasible in tertiary care centers. The use of targeted active surveillance for MRSA in patients and healthcare workers in specific wards (identified by means of analysis of clinical epidemiology data) and the use of decolonization were key to the success of the program.
PB The University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America
SN 0899-823X
YR 2010
FD 2010-08-31
LK http://hdl.handle.net/10668/360
UL http://hdl.handle.net/10668/360
LA en
NO Rodríguez-Baño J, García L, Ramírez E, Lupión C, Muniain MA, Velasco C, et al. Long-Term Control of Endemic Hospital-Wide Methicillin-Resistant Staphylococcus aureus (MRSA): The Impact of Targeted Active Surveillance for MRSA in Patients and Healthcare Workers. Infect Control Hosp Epidemiol 2010; Vol. 31, No. 8 (August 2010), pp. 786-795
DS RISalud
RD Apr 20, 2025