Curbing hospital acquired MRSA infections

January 01, 0001

Curbing hospital acquired MRSA infections

These French authors describe the outcomes of a program aimed at curbing the methcillin resistant Staphylococcus aureus (MRSA) burden, which was launched in 1993. It is based on passive and active surveillance, barrier precautions, training, and feedback. This program, supported by the strong commitment of the institution, was reinforced in 2001 by a campaign promoting the use of alcohol-based hand-rub (ABHR) solutions. An observational study on MRSA rate was prospectively carried out from 1993 onwards.

They found: "There was a significant progressive decrease in MRSA burden (-35%) from 1993 to 2007, whether recorded as the proportion (expressed as percentage) of MRSA among S aureus strains (41.0% down to 26.6% overall; 45.3% to 24.2% in blood cultures) or incidence of MRSA cases (0.86 down to 0.56 per 1000 hospital days). The MRSA burden decreased more markedly in intensive care units (-59%) than in surgical (-44%) and medical (-32%) wards. The use of ABHR solutions (in liters per 1000 hospital days) increased steadily from 2 L to 21 L (to 26 L in acute care hospitals and to 10 L in rehabilitation and long-term care hospitals) following the campaign."

The authors concluded: "A sustained reduction of MRSA burden can be obtained at the scale of a large hospital institution with high endemic MRSA rates, providing that an intensive program is maintained for a long period."

It is helpful to know the magnitude of effect of such programs.

For the full abstract, click here.

Arch Intern Med 170(6):552-559, 22 March 2010
© 2010 to the American Medical Association
Curbing Methicillin-Resistant Staphylococcus aureus in 38 French Hospitals Through a 15-Year Institutional Control Program. Vincent Jarlier, David Trystram, Christian Brun-Buisson, et al. Correspondence to Dr. Jarlier:

Category: HSR. Health Services Research. Keywords: methcillin-resistant Staphylococcus aureus, MRSA, hospital-acquired infections, prevention, observational study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 6 April 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.