Avtor/Urednik		Tomič, Viktorija; Svetina-Šorli, Petra; Trinkaus, Darinka; Šorli, Jurij; Widmer, Andreas F; Trampuž, Andrej
Naslov		Comprehensive strategy to prevent nosocomial spread of methicillin-resistant Staphylococcus aureus in a highly endemic setting
Tip		članek
Vir		Arch Intern Med
Vol. in št.		Letnik 164
Leto izdaje		2004
Obseg		str. 2038-43
Jezik		eng
Abstrakt		Background: The effectiveness and feasibility of a comprehensive strategy to reduce nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in a highly endemic setting has not yet been proven. Limited benefits and high cost of such programs are the main conceras. Methods: We prospectively evaluated the impact of an aggressive infection control program on transmission of MRSA in the University Clinic of Respiratory and Allergic Diseases. All patients with MRSA carriage over a period of 5 years (January 1998 through December 2002) were included and categorized into imported or hospital-acquired cases. Results: MRSA was recovered from 223 hospitalized patients; 142 cases were imported and 81 were acquired at our institution. After introduction of the comprehensive infection control program in 1999, the annual incidence of MRSA carriage per 1000 admissions increased from 4.5 in 1998 to 8.0 in 1999 (P = 0.019), and remained stable thereafter. In this period, the proportion of MRSA cases acquired in our institution decreased from 50% in 1999 to 6% in 2002 (P <0.001), whereas the proportion of MRSA cases transferred from other hospitals (P <0.001) and nursing homes (P = 0.025) increased. All 19 MRSA carriers with three sets of follow-up cultures were successfully decolonized. Conclusions: With a comprehensive infection control program it was possible to reduce nosocomial transmission of MRSA in a highly endemic area. With good hand hygiene using the alcohol hand rub, early detection, isolation and decolonization strategy, containment of MRSA was achievable despite a high rate of transferred patients with MRSA.
Deskriptorji		STAPHYLOCOCCAL INFECTIONS CROSS INFECTION STAPHYLOCOCCUS AUREUS METHICILLIN RESISTANCE HANDWASHING PROSPECTIVE STUDIES