All Journals > Infection Control and Hospital Epidemiology > July 2007 > Reduction in MRSA With Use of Hand Rub and SPC Charts

Article Tools

Search for Related Articles

  • By Author
  • Search In

Announcements

Highlighted Article

NHSN Annual Update:
Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections

Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007

Antimicrobial-resistant pathogens that cause healthcare-associated infections (HAIs) pose an ongoing and increasing challenge to hospitals, both in the clinical treatment of patients and in the prevention of the cross-transmission of these problematic pathogens.  Describing the magnitude of the problem with respect to these antimicrobial-resistant pathogens is challenging, because the levels of antimicrobial resistance vary for different types of healthcare facilities and for different geographic areas, and some resistance phenotypes are difficult for laboratories to detect. However, the findings from such attempts may help the infection control and public health communities target problems and utilize resources more efficiently.

In the News

Featured in The Times
"Ireland 'losing war' on superbug" February 15, 2009
Challenges of Implementing National Guidelines for the Control and Prevention of Methicillin‐Resistant Staphylococcus aureus Colonization or Infection in Acute Care Hospitals in the Republic of Ireland
Fidelma Fitzpatrick, MD; Fiona Roche, PhD; Robert Cunney, MB; Hilary Humphreys, MD; Strategy for the Control of Antimicrobial Resistance in Ireland Infection Control Subcommittee
The research, published in Infection Control and Hospital Epidemiology, found one third of hospitals did not have a written policy on antibiotic use, and only 35% had an antibiotic stewardship programme.

July 2007

Volume 28, Number 7
Infect Control Hosp Epidemiol 2007;28:837–844
© 2007 by The Society for Healthcare Epidemiology of America. All rights reserved.
0899-823X/2007/2807-0011$15.00
DOI: 10.1086/518844
Original Article

Reduction in Hospitalwide Incidence of Infection or Colonization with Methicillin‐Resistant Staphylococcus aureus With Use of Antimicrobial Hand‐Hygiene Gel and Statistical Process Control Charts

Glenys Harrington, RN, RM;

Kerrie Watson, MSc;

Michael Bailey, PhD;

Gillian Land, RN, RM, BEd;

Susan Borrell, RN;

Leanne Houston, RN, BAppSc (Nsg);

Rosaleen Kehoe, RN;

Pauline Bass, RN, BSc (Nsg);

Emma Cockroft, RN, BNsg;

Caroline Marshall, FRACP, PhD;

Anne Mijch, MB, BS (Hons), FRACP;

Denis Spelman, FRCPA, FRACP

From the Infection Control and Hospital Epidemiology Unit (G.H., K.W., G.L., S.B., L.H., R.K., P.B., A.M., D.S.) and the Infectious Diseases Unit (E.C., A.M., D.S.), the Alfred Hospital, Bayside Health, the Department of Epidemiology and Preventive Medicine, Monash University (M.B., C.M., D.S.), and the Centre for Clinical Research Excellence in Infectious Diseases, University of Melbourne (C.M.), Melbourne, Australia.

Objective.To evaluate the impact of serial interventions on the incidence of methicillin‐resistant Staphylococcus aureus (MRSA).

Design.Longitudinal observational study before and after interventions.

Setting.The Alfred Hospital is a 350‐bed tertiary referral hospital with a 35‐bed intensive care unit (ICU).

Interventions.A series of interventions including the introduction of an antimicrobial hand‐hygiene gel to the intensive care unit and a hospitalwide MRSA surveillance feedback program that used statistical process control charts but not active surveillance cultures.

Methods.Serial interventions were introduced between January 2003 and May 2006. The incidence and rates of new patients colonized or infected with MRSA and episodes of MRSA bacteremia in the intensive care unit and hospitalwide were compared between the preintervention and intervention periods. Segmented regression analysis was used to calculate the percentage reduction in new patients with MRSA and in episodes of MRSA bacteremia hospitalwide in the intervention period.

Results.The rate of new patients with MRSA in the ICU was 6.7 cases per 100 patient admissions in the intervention period, compared with 9.3 cases per 100 patient admissions in the preintervention period ( ). The hospitalwide rate of new patients with MRSA was 1.7 cases per 100 patient admissions in the intervention period, compared with 3.0 cases per 100 patient admissions in the preintervention period ( ). By use of segmented regression analysis, the maximum and conservative estimates for percentage reduction in the rate of new patients with MRSA were 79.5% and 42.0%, respectively, and the maximum and conservative estimates for percentage reduction in the rate of episodes of MRSA bacteremia were 87.4% and 39.0%, respectively.

Conclusion.A sustained reduction in the number of new patients with MRSA colonization or infection has been demonstrated using minimal resources and a limited number of interventions.

Received October 9, 2006; accepted December 15, 2006; electronically published May 31, 2007.

Address reprint requests to Glenys Harrington, RN, RM, Infection Control and Hospital Epidemiology Unit, the Alfred Hospital, Commercial Rd., Melbourne, Victoria 3004 Australia ().

Cited by

Klaus Kaier, Dipl‐Vw; Christian Hagist, PhD; Uwe Frank, MD; Andreas Conrad, MD; Elisabeth Meyer, MD. (2009) Two Time‐Series Analyses of the Impact of Antibiotic Consumption and Alcohol‐Based Hand Disinfection on the Incidences of Nosocomial Methicillin‐Resistant Staphylococcus aureus Infection and Clostridium difficile Infection •. Infection Control and Hospital Epidemiology 30:4, 346-353
Online publication date: 1-Apr-2009.
Abstract-Full Text-PDF Version (505 kB)
J. Szabó, Z. Dombrádi, O. Dobay, P. Orosi, J. Kónya, K. Nagy, F. Rozgonyi. (2009) Phenotypic and genetic characterisation of methicillin-resistant Staphylococcus aureus strains isolated from the university hospitals of Debrecen. European Journal of Clinical Microbiology & Infectious Diseases 28:2, 129-136
Online publication date: 1-Mar-2009.
CrossRef
By Mette Walberg, PhD; Kathrine Frey Frøslie, MSc; Jo Røislien, PhD. (2008) Local Hospital Perspective on a Nationwide Outbreak of Pseudomonas aeruginosa Infection in Norway. Infection Control and Hospital Epidemiology 29:7, 635-641
Online publication date: 1-Jul-2008.
Abstract-Full Text-PDF Version (293 kB)
H. Humphreys. (2008) Can we do better in controlling and preventing methicillin-resistant Staphylococcus aureus (MRSA) in the intensive care unit (ICU)?. European Journal of Clinical Microbiology & Infectious Diseases 27:6, 409-413
Online publication date: 1-Jul-2008.
CrossRef
Ilker Uçkay, Stephan Harbarth, Didier Pittet. (2008) Management of Gram-positive bacteraemia. Current Opinion in Infectious Diseases 20:6, 561-567
Online publication date: 1-Jan-2008.
CrossRef
Hilary Humphreys, MD, FRCPI, FRCPath, Dip HIC. (2007) Understanding Why Methicillin‐Resistant Staphylococcus aureus Control Measures Are Successful in Different Countries •. Infection Control and Hospital Epidemiology 28:12, 1418-1419
Online publication date: 1-Dec-2007.
Citation-Full Text-PDF Version (118 kB)

  • Presented in part: Hong Kong Infection Control Nurses’ Association, 2nd International Infection Control Conference; Hong Kong; June 16‐18, 2006 (Abstract 18); and the Australian Infection Control Association, 4th Biennial National Conference; Sydney, Australia; September 20‐22, 2006 (p. 39).

Back to Top
Close Popup