Case Study: An MRSA Intervention at Evanston Northwestern Healthcare

被引:38
作者
Peterson, Lance R. [1 ,2 ,3 ,4 ]
Hacek, Donna M. [3 ,5 ]
Robicsek, Ari [4 ,6 ]
机构
[1] Northwestern Univ, Feinberg Sch Med, Dept Med, Evanston, IL 60208 USA
[2] Northwestern Univ, Feinberg Sch Med, Dept Pathol, Evanston, IL USA
[3] Evanston Northwestern Healthcare, Dept Pathol & Lab Med, Div Microbiol, Evanston, IL USA
[4] Evanston Northwestern Healthcare, Dept Med, Div Infect Dis, Evanston, IL USA
[5] Evanston Northwestern Healthcare, Dept Pathol, Evanston, IL USA
[6] Evanston Northwestern Healthcare, Dept Med, Feinberg Sch Med, Evanston, IL USA
关键词
D O I
10.1016/S1553-7250(07)33088-2
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
PCR-based testing offers superiority to culture in reduction of unisolated days. The ICU-based surveillance intervention had little impact after one year with surveillance compliance at 67%. However, once compliance improved, surveillance was expanded to the entire hospital and decolonization was implemented, MRSA BSIs were significantly reduced. Our experience parallels that of the European countries and other United States facilities that have implemented aggressive MRSA control measures. All successful programs have included active surveillance testing and barrier precautions. Finally, according to the Centers lor Disease Control and Prevention's just-released report on invasive MRSA, since most MRSA infections are associated with health care contact,21 strategies to prevent and control MRSA among inpatients still may have a positive impact on infection, as demonstrated by our intervention.
引用
收藏
页码:732 / 738
页数:7
相关论文
共 20 条
[1]   A laboratory-based, hospital-wide, electronic marker for nosocomial infection - The future of infection control surveillance? [J].
Brossette, SE ;
Hacek, DM ;
Gavin, PJ ;
Kamdar, MA ;
Gadbois, KD ;
Fisher, AG ;
Peterson, LR .
AMERICAN JOURNAL OF CLINICAL PATHOLOGY, 2006, 125 (01) :34-39
[2]   Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia:: A meta-analysis [J].
Cosgrove, SE ;
Sakoulas, G ;
Perencevich, EN ;
Schwaber, MJ ;
Karchmer, AW ;
Carmeli, Y .
CLINICAL INFECTIOUS DISEASES, 2003, 36 (01) :53-59
[3]   The impact of methicillin-resistance in Staphylococcus aureus bacteremia on patient outcomes:: Mortality, length of stay, and hospital charges [J].
Cosgrove, SE ;
Qi, YL ;
Kaye, KS ;
Harbarth, S ;
Karchmer, AW ;
Carmeli, Y .
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2005, 26 (02) :166-174
[4]   Temporal changes in prevalence of antimicrobial resistance in 23 US hospitals [J].
Fridkin, SK ;
Hill, HA ;
Volkova, NV ;
Edwards, JR ;
Lawton, RM ;
Gaynes, RP ;
McGowan, JE .
EMERGING INFECTIOUS DISEASES, 2002, 8 (07) :697-701
[5]   Reducing Methicillin-Resistant Staphylococcus aureus (MRSA) Infections [J].
Griffin, Frances A. .
JOINT COMMISSION JOURNAL ON QUALITY AND PATIENT SAFETY, 2007, 33 (12) :726-731
[6]   Risk of methicillin-resistant Staphylococcus aureus infection after previous infection or colonization [J].
Huang, SS ;
Platt, R .
CLINICAL INFECTIOUS DISEASES, 2003, 36 (03) :281-285
[7]  
Jernigan JA, 1996, AM J EPIDEMIOL, V143, P496, DOI 10.1093/oxfordjournals.aje.a008770
[8]   Prevalence of and risk factors for colonization with methicillin-resistant Staphylococcus aureus at the time of hospital admission [J].
Jernigan, JA ;
Pullen, AL ;
Flowers, L ;
Bell, M ;
Jarvis, WR .
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2003, 24 (06) :409-414
[9]   Invasive methicillin-resistant Staphylococcus aureus infections in the United States [J].
Klevens, R. Monina ;
Morrison, Melissa A. ;
Nadle, Joelle ;
Petit, Susan ;
Gershman, Ken ;
Ray, Susan ;
Harrison, Lee H. ;
Lynfield, Ruth ;
Dumyati, Ghinwa ;
Townes, John M. ;
Craig, Allen S. ;
Zell, Elizabeth R. ;
Fosheim, Gregory E. ;
McDougal, Linda K. ;
Carey, Roberta B. ;
Fridkin, Scott K. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 298 (15) :1763-1771
[10]   Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992-2003 [J].
Klevens, RM ;
Edwards, JR ;
Tenover, FC ;
McDonald, LC ;
Horan, T ;
Gaynes, R .
CLINICAL INFECTIOUS DISEASES, 2006, 42 (03) :389-391