Impact of routine surgical and intensive care units admission surveillance cultures on hospital-wide nosocomial MRSA infections in a university hospital
Abstract number: O142
Chaberny I.F., Schwab F., Ziesing S., Suerbaum S., Gastmeier P.
Objectives: Despite the existence of an established infection control programme to combat MRSA transmission that includes effective barrier precautions, an alert system for readmitted MRSA patients and screening of roommates, a steady increase in nosocomial MRSA infections was observed at Hannover Medical School a 1400-bed university hospital in 2004. In reaction to this, an extended admission screening policy was established in mid-2004 which included surgical wards and intensive care units (ICUs). The aim of this study was to assess the impact of this intervention.
Methods: The study used a single-centre prospective quasi-experimental design to evaluate the effect of MRSA admission screening policy on the incidence density of nosocomial MRSA infected patients per 1000 patient-days (MRSA-infpat/1000pd) in the whole hospital. The screening policy was implemented during a six month period (July to December 2004). The effect on MRSA-infpat/1000 pd was calculated by segmented regression analysis of interrupted time series with 30 months prior and 24 months after the implementation period.
Results: As a consequence of the implementation of admission screening, the number of surveillance cultures increased nine-fold increase, from 2.3 in 2002 to 20.4 nares cultures per 1000 patient-days in 2006. The intervention had a highly significant hospital-wide effect on the incidence density of MRSA infections. Segmented regression analysis showed both a significant change in level (-0.122 MRSA-infpat/1000pd, 95% CI, -0.205 to -0.004) and a significant change in slope (-0.008 MRSA-infpat/1000pd per month, 95% CI, -0.013 to -0.003) after the intervention. A decrease of MRSA infections by 63% is a conservative estimate of the reduction between the last month before intervention (0.259 MRSA-infpat/1000pd) and the last month in the analysed post-intervention period (0.096 MRSA-infpat/1000pd).
Conclusion: This is the first hospital-wide study which investigates the impact of introducing admission screening in ICUs and non-ICU wards as single intervention to prevent nosocomial MRSA infections performed with a time series regression analysis. Admission screening is a potent tool in controlling the spread of MRSA infections in hospitals.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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