Two-stage evaluation and intervention program for control of methicillin-resistant Staphylococcus aureus in the hospital setting

The aim of this study was to develop a 2-stage evaluation and intervention program for control of methicillin-resistant Staphylococcus aureus (MRSA) in the hospital setting. The first stage included evaluation of MRSA prevalence throughout the entire hospital; the presence of MRSA was determined in patients or medical staff who had a high risk of carrying it (i.e. as a result of contact with surgical wounds). In the second stage, "contact isolation" (which included the use of gloves, hand washing before and after treatment of a patient and isolation of patients' personal belongings) was carried out in every patient from whom MRSA was isolated in 4 intervention departments-Surgery, Orthopaedics, General ICU and Neonatal ICU-while the same policy of attempting to isolate MRSA was maintained. Both stages lasted 7 months. A comparison between MRSA prevalence in the evaluation and intervention stages disclosed a decrease in MRSA isolates from 91 to 56 in the entire hospital (p=0.2) and from 45 to 24 in the intervention departments (p=0.05), respectively; while the number of patients with MRSA decreased from 87 to 55 in the entire hospital (p=0.2) and from 45 to 18 in the intervention departments (p=0.007). The number of patients treated with vancomycin decreased from 48 before intervention to 23 after "contact isolation" was started in the entire hospital (p=0.02) and from 31 to 5 in the intervention departments (p=0.001). These results provide additional evidence in favor of establishing a program to control MRSA spread.