Effect of search-and-destroy policy on Staphylococcus aureus bacteraemia and overall methicillin-resistant S.aureus rates: experience from neurosurgery clinic of a tertiary-care educational university hospital with endemic MRSA
Abstract number: P1540
Sipahi O., Arda B., Bayram A., Aydemir S., Turhan T., Cilli F., Sipahi H., Ulusoy S.
Objectives:S. aureus is one of the most important etiologic agents in nosocomial infections. Search&destroy policy is effective for preventing S. aureus infections in settings with low MRSA rates. The aim of this study was to evaluate the effect of search&destroy policy on S. aureus bacteremia, meningitis and overall MRSA rates in neurosurgery clinic of a developing world tertiary-care educational university hospital where MRSA is endemic.
Method: This study was performed at a tertiary care general teaching hospital with an active neurosurgery ward with 78 beds, 16 of which are in intensive care unit. After 1 July 2008, patients admitting to neurosurgery intensive care unit of our setting were sampled for nasal S. aureus carriage. Bacteriologic culture and identification of S. aureus from any sample was performed with conventional methods. Antibacterial susceptibility testing was performed with disk-diffusion test according to CLSI criteria. Cases who had nasal S. aureus carriage were treated with nasal bacitracin ointment (three times a day, for three days, control culture performed on day 56). Cases with MRSA carriage were put under contact isolation. Resistance patterns of the samples, total number of patients and patient days in the overall neurosurgery clinic (including both ICU beds and normal beds) were retrieved from hospital records database. The preintervention period was considered as January 20072008 June and post intervention period was considered as July 2008-October 2009.
Results: Overall S. aureus bacteremia rate decreased significantly (20/3651 cases and 0.41/1000 patient days vs 6/2959 and 0.2/1000 patient days, p = 0.02). Overall S. aureus meningitis rate did not change significantly (4/3651 vs 8/2959, p < 0.05). MRSA rate in any clinical sample (only one sample from each case) did not change significantly (55/99 versus 38/61 p > 0.05).
Conclusion: Despite the fact that the search&destroy policy was performed in only ICU cases, overall bacteremia rate decreased significantly. However overall MRSA rate did not change. Our findings suggest that this strategy may be beneficial in resource-limited countries where bacteremia is a significant problem.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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