Minimal intervention for controlling nosocomial transmission of methicillin-resistant staphylococcus aureus in resource limited setting with high endemicity.

<h4>Objective</h4>To control nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in resource-limited healthcare setting with high endemicity.<h4>Methods</h4>Three phases of infection control interventions were implemented in a University-affiliated h...

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Autores principales:	Vincent Chi-Chung Cheng, Josepha Wai-Ming Tai, Pui-Hing Chau, Jonathan Hon-Kwan Chen, Mei-Kum Yan, Simon Yung-Chun So, Kelvin Kai-Wang To, Jasper Fuk-Woo Chan, Sally Cheuk-Ying Wong, Pak-Leung Ho, Kwok-Yung Yuen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/446e264f2b0046c9b1b0be7d1bc7fd3c
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spelling	oai:doaj.org-article:446e264f2b0046c9b1b0be7d1bc7fd3c2021-11-18T08:15:01ZMinimal intervention for controlling nosocomial transmission of methicillin-resistant staphylococcus aureus in resource limited setting with high endemicity.1932-620310.1371/journal.pone.0100493https://doaj.org/article/446e264f2b0046c9b1b0be7d1bc7fd3c2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24945412/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To control nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in resource-limited healthcare setting with high endemicity.<h4>Methods</h4>Three phases of infection control interventions were implemented in a University-affiliated hospital between 1-January-2004 and 31-December-2012. The first phase of baseline period, defined as the first 48-months of the study period, when all MRSA patients were managed with standard precautions, followed by a second phase of 24-months, when a hospital-wide hand hygiene campaign was launched. In the third phase of 36-months, contact precautions in open cubicle, use of dedicated medical items, and 2% chlorhexidine gluconate daily bathing for MRSA-positive patients were implemented while hand hygiene campaign was continued. The changes in the incidence rates of hospital-acquired MRSA-per-1000-patient admissions, per-1000-patient-days, and per-1000-MRSA-positive-days were analyzed using segmented Poisson regression (an interrupted time series model). Usage density of broad-spectrum antibiotics was monitored.<h4>Results</h4>During the study period, 4256 MRSA-positive patients were newly diagnosed, of which 1589 (37.3%) were hospital-acquired. The reduction of hospital-acquired MRSA per 1000-patient admissions, per 1000-patient-days, and per 1000-MRSA-positive-days from phase 1 to 2 was 36.3% (p<0.001), 30.4% (p<0.001), and 19.6% (p = 0.040), while the reduction of hospital-acquired MRSA per 1000-patient admissions, per 1000-patient-days, and per 1000-MRSA-positive-days from phase 2 to 3 was 27.4% (p<0.001), 24.1% (p<0.001), and 21.9% (p = 0.041) respectively. This reduction is sustained despite that the usage density of broad-spectrum antibiotics has increased from 132.02 (phase 1) to 168.99 per 1000 patient-days (phase 3).<h4>Conclusions</h4>Nosocomial transmission of MRSA can be reduced with hand hygiene campaign, contact precautions in open cubicle, and 2% chlorhexidine gluconate daily bathing for MRSA-positive despite an increasing consumption of broad-spectrum antibiotics.Vincent Chi-Chung ChengJosepha Wai-Ming TaiPui-Hing ChauJonathan Hon-Kwan ChenMei-Kum YanSimon Yung-Chun SoKelvin Kai-Wang ToJasper Fuk-Woo ChanSally Cheuk-Ying WongPak-Leung HoKwok-Yung YuenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 6, p e100493 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Vincent Chi-Chung Cheng Josepha Wai-Ming Tai Pui-Hing Chau Jonathan Hon-Kwan Chen Mei-Kum Yan Simon Yung-Chun So Kelvin Kai-Wang To Jasper Fuk-Woo Chan Sally Cheuk-Ying Wong Pak-Leung Ho Kwok-Yung Yuen Minimal intervention for controlling nosocomial transmission of methicillin-resistant staphylococcus aureus in resource limited setting with high endemicity.
description	<h4>Objective</h4>To control nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in resource-limited healthcare setting with high endemicity.<h4>Methods</h4>Three phases of infection control interventions were implemented in a University-affiliated hospital between 1-January-2004 and 31-December-2012. The first phase of baseline period, defined as the first 48-months of the study period, when all MRSA patients were managed with standard precautions, followed by a second phase of 24-months, when a hospital-wide hand hygiene campaign was launched. In the third phase of 36-months, contact precautions in open cubicle, use of dedicated medical items, and 2% chlorhexidine gluconate daily bathing for MRSA-positive patients were implemented while hand hygiene campaign was continued. The changes in the incidence rates of hospital-acquired MRSA-per-1000-patient admissions, per-1000-patient-days, and per-1000-MRSA-positive-days were analyzed using segmented Poisson regression (an interrupted time series model). Usage density of broad-spectrum antibiotics was monitored.<h4>Results</h4>During the study period, 4256 MRSA-positive patients were newly diagnosed, of which 1589 (37.3%) were hospital-acquired. The reduction of hospital-acquired MRSA per 1000-patient admissions, per 1000-patient-days, and per 1000-MRSA-positive-days from phase 1 to 2 was 36.3% (p<0.001), 30.4% (p<0.001), and 19.6% (p = 0.040), while the reduction of hospital-acquired MRSA per 1000-patient admissions, per 1000-patient-days, and per 1000-MRSA-positive-days from phase 2 to 3 was 27.4% (p<0.001), 24.1% (p<0.001), and 21.9% (p = 0.041) respectively. This reduction is sustained despite that the usage density of broad-spectrum antibiotics has increased from 132.02 (phase 1) to 168.99 per 1000 patient-days (phase 3).<h4>Conclusions</h4>Nosocomial transmission of MRSA can be reduced with hand hygiene campaign, contact precautions in open cubicle, and 2% chlorhexidine gluconate daily bathing for MRSA-positive despite an increasing consumption of broad-spectrum antibiotics.
format	article
author	Vincent Chi-Chung Cheng Josepha Wai-Ming Tai Pui-Hing Chau Jonathan Hon-Kwan Chen Mei-Kum Yan Simon Yung-Chun So Kelvin Kai-Wang To Jasper Fuk-Woo Chan Sally Cheuk-Ying Wong Pak-Leung Ho Kwok-Yung Yuen
author_facet	Vincent Chi-Chung Cheng Josepha Wai-Ming Tai Pui-Hing Chau Jonathan Hon-Kwan Chen Mei-Kum Yan Simon Yung-Chun So Kelvin Kai-Wang To Jasper Fuk-Woo Chan Sally Cheuk-Ying Wong Pak-Leung Ho Kwok-Yung Yuen
author_sort	Vincent Chi-Chung Cheng
title	Minimal intervention for controlling nosocomial transmission of methicillin-resistant staphylococcus aureus in resource limited setting with high endemicity.
title_short	Minimal intervention for controlling nosocomial transmission of methicillin-resistant staphylococcus aureus in resource limited setting with high endemicity.
title_full	Minimal intervention for controlling nosocomial transmission of methicillin-resistant staphylococcus aureus in resource limited setting with high endemicity.
title_fullStr	Minimal intervention for controlling nosocomial transmission of methicillin-resistant staphylococcus aureus in resource limited setting with high endemicity.
title_full_unstemmed	Minimal intervention for controlling nosocomial transmission of methicillin-resistant staphylococcus aureus in resource limited setting with high endemicity.
title_sort	minimal intervention for controlling nosocomial transmission of methicillin-resistant staphylococcus aureus in resource limited setting with high endemicity.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/446e264f2b0046c9b1b0be7d1bc7fd3c
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Minimal intervention for controlling nosocomial transmission of methicillin-resistant staphylococcus aureus in resource limited setting with high endemicity.

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