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  • Open Access

P044: MRSA-infection prevention potential in a 500-beds tertiary care hospital

  • F Mattner1,
  • D Peter1,
  • C Weßels1 and
  • S Messler1
Antimicrobial Resistance and Infection Control20132(Suppl 1):P44

https://doi.org/10.1186/2047-2994-2-S1-P44

Published: 20 June 2013

Keywords

ChlorhexidineTertiary Care HospitalBlood Stream InfectionIsolation PrecautionContact Isolation

Introduction

Many studies of infection prevention measures (ICM) appear proving a reduction of methicillin-resistant Staphylococcus aureus (MRSA) - colonisation or - infection rates. Infection control personal has to decide if ICM should be introduced in their hospital. Here we give an example how an infection prevention potential (IPP) could be calculated for MRSA patients in a 500-bed tertiary care hospital under a given MRSA-screening, contact isolation precaution and active surveillance program.

Objectives

To estimate an additional IPP using results of recently published ICM, demonstrated by daily body washes with chlorhexidine (CHX) for the reduction of blood stream infections (BSI)(Climo MW et al. 2013), limited to S. aureus infections.

Methods

MRSA screening policy included a general screening for all medical wards and the intensive care unit; in all other ward screening was performed as recommended by the Robert-Koch-Institut. A culture based screening (BD CHROMAgar MRSA II) was performed except PCR-based (Roche LightCycler®Advanced) screening in the intensive care unit. We reported results when MRSA was suspected. Distinct subgroups of MRSA patients were defined as I/II: colonisation on admission/nosocomial acquired colonisation without infection during hospital stay; III: nosocomial MRSA infection after colonisation status at least 3 days before infection. IV: nosocomial MRSA infection without prior colonisation, V: infection already present on admission.

Results

In 2011 and 2012, I were 266/225, II: 19/30, III: 23/12, IV: 12/5. V: 25/18 patients, respectively. Preventable infections were III with 23 per 332 and 12 per 285 MRSA cases in 2011 and 2012 respectively, yielding a prevention potential of only 6,9% and 4,2% of all MRSA positive patients. There were 17 primary and secondary BSIs. Calculating with 8% reduction for S. aureus BSI by CHX body washes reported by Climo they would prevent only one case in our hospital within two years.

Conclusion

Before introduction of new ICM proposed by new studies MRSA patients could be subgrouped and an IPP can be determined. Applying published reduction data on the in-house IPP numbers gives a first estimate if the new ICM could be a benefit.

Disclosure of interest

None declared

Authors’ Affiliations

(1)
Institut für Hygiene, Kliniken der Stadt Köln, Cologne, Germany

References

  1. Climo MW et al: Effect of daily chlorhexidin bathing on hospital-aquired infections. N Engl J Med. 2013, 368: 533-542. 10.1056/NEJMoa1113849.View ArticlePubMedGoogle Scholar

Copyright

© Mattner et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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