A purpose built MRSA cohort unit

被引:27
作者
Fitzpatrick, F [1 ]
Murphy, OM [1 ]
Brady, A [1 ]
Prout, S [1 ]
Fenelon, LE [1 ]
机构
[1] St Vincents Univ Hosp, Dept Clin Microbiol, Dublin 4, Ireland
关键词
MRSA; cohort unit; colonization; environmental;
D O I
10.1053/jhin.2000.0838
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The control of hospital-acquired infection, in particular methicillin-resistant Staphylococcus aureus (MRSA) remains a challenge. Our hospital has established a purpose built Ii-bed cohort unit with on-site rehabilitation for care of patients colonized with MRSA, in an attempt to improve their quality of care. Prior to the opening of this unit a number of concerns were voiced and the aim of this study was to address these. First, to establish if patient cohorting reduces the likelihood of successful decolonization, second, to evaluate the risk of staff colonization, and finally to see if successful environmental control of MRSA is possible. A patient database was established detailing patient demographics, infection rates, eradication and reacquisition rates. Staff screening aias performed weekly, at the start of a period of duty Sixty environmental sites were screened before unit opening, at 48 h, six weeks and at six months. There were 88 admissions in the first six months; 62 patients were colonized with MRSA, and 26 patients (10 surgical, 16 medical) had MRSA infections. Twenty-three of 88 patients (26%) were successfully decolonized, which compares favourably with an eradication rate of 20% for the rest of the hospital. Twenty staff members participated in weekly screening. Five staff members colonized with MRSA were detected and all were successfully decolonized. Environmental control was achieved with a combination of a daily detergent clean and a once weekly clean with phenolic disinfectant. Our preliminary data suggest that, despite cohorting patients colonized with MRSA, with proper education and supervised cleaning protocols, it is possible to control environmental MRSA load, successfully decolonize patients and limit the risk of staff colonization. (C) 2000 The Hospital infection Society.
引用
收藏
页码:271 / 279
页数:9
相关论文
共 39 条
  • [1] Ayliffe GAJ, 1998, J HOSP INFECT, V39, P253, DOI 10.1016/S0195-6701(98)90293-6
  • [2] CONTROL AND ERADICATION OF METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS ON A SURGICAL UNIT
    BARTZOKAS, CA
    PATON, JH
    GIBSON, MF
    GRAHAM, R
    MCLOUGHLIN, GA
    CROTON, RS
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1984, 311 (22) : 1422 - 1425
  • [3] Environmental contamination due to methicillin-resistant Staphylococcus aureus (MRSA)
    Blythe, D.
    Keenlyside, D.
    Dawson, S. J.
    Galloway, A.
    [J]. JOURNAL OF HOSPITAL INFECTION, 1998, 38 (01) : 67 - 69
  • [4] SPREAD OF METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS IN A HOSPITAL AFTER EXPOSURE TO A HEALTH-CARE WORKER WITH CHRONIC SINUSITIS
    BOYCE, JM
    OPAL, SM
    POTTERBYNOE, G
    MEDEIROS, AA
    [J]. CLINICAL INFECTIOUS DISEASES, 1993, 17 (03) : 496 - 504
  • [5] BURN UNITS AS A SOURCE OF METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS INFECTIONS
    BOYCE, JM
    WHITE, RL
    CAUSEY, WA
    LOCKWOOD, WR
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1983, 249 (20): : 2803 - 2807
  • [6] Boyce JM, 1997, INFECT CONT HOSP EP, V18, P622
  • [7] BRADLEY JM, 1985, LANCET, V1, P1493
  • [8] METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS - COLONIZATION AND INFECTION IN A LONG-TERM CARE FACILITY
    BRADLEY, SF
    TERPENNING, MS
    RAMSEY, MA
    ZARINS, LT
    JORGENSEN, KA
    SOTTILE, WS
    SCHABERG, DR
    KAUFFMAN, CA
    [J]. ANNALS OF INTERNAL MEDICINE, 1991, 115 (06) : 417 - 422
  • [9] STAFF CARRIAGE OF EPIDEMIC METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS
    COOKSON, B
    PETERS, B
    WEBSTER, M
    PHILLIPS, I
    RAHMAN, M
    NOBLE, W
    [J]. JOURNAL OF CLINICAL MICROBIOLOGY, 1989, 27 (07) : 1471 - 1476
  • [10] COOKSON BD, 1985, LANCET, V2, P218