Reduction in the incidence of staphylococcal infections in hospital environment after the starting of the guideline of perioperative antibiotic prophylaxis
Abstract number: p895
Gattuso G., Tomasoni D., Palvarini L., Berra D., Chiarelli C., Stradoni R., Scalzini A.
Nosocomial infections caused by MRSA are increasing; moreover only few studies concerning the trend of MRSA after the application of perioperative antibiotic prophylaxis (PAP) guideline have been conducted.
Comparing the general incidence of staphylococcal and MRSA infections in the Hospital of Mantua versus the incidence of staphylococcal and MRSA in the surgical wards after the introduction of PAP's guideline.
The hospital is a 530-bed tertiary care teaching hospital in Mantua with 30,000 patients admission per year. Two periods have been compared: 2nd Six Months (S) of 2002-1st S of 2003 (period A) and 2nd S of 2003-1st S of 2004 (period B), respectively before and after the introduction of the guideline of PAP. Statistical analysis has been performed using Mercurio (DIANOEMA) software; the rates of incidence of Staphylococcal and MRSA infections has been compared using the Fisher test.
In the period A 10407 microbiological examinations have been executed; 637/10407 cases (6.1%) were positive for S. aureus and 119/637 (18.6%) were MRSA. In the period B 8421 microbiological exams have been performed: 315/8421 (3.7%) S. aureus and 81/315 (25.7%) MRSA. In the period A a significant increase of MRSA was found in the surgical wards comparing to the other wards: 58.6% vs 22.9% (p = 0.001), whereas in the period B was checked a relevant decrease of MRSA in the surgical wards compared to the general data (25.0% vs 25.7%) (p = ns). In the second period the data of MRSA in the surgical wards were found significantly reduced (58.6% vs 25.0%) (p = 0.001). Moreover in the period B the global antibiotic consumption was reduced with an increment of the cephalosporins of 1st generation (+11.5% of cephazolin) used correctly in surgical prophylaxis, while a remarkable decrease of consumption of cephalosporin of 3rd and 4th generation (respectively: -59% and -12.7%).
12 months after the introduction of PAP a significant reduction of incidence of MRSA infections was found in the surgical wards; moreover such result can be ascribed to a greater adhesion to norms of "good clinical practice".
|Session name:||XXIst ISTH Congress|
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