Decrease of infection rate of methicillin resistant Staphylococcus aureus acquired in a French intensive care unit, under reinforcement of specific isolation.

Decrease of infection rate of methicillin resistant Staphylococcus aureus acquired in a French intensive care unit, under reinforcement of specific isolation. Objectives - The authors wanted to assess the impact of an "isolation" reinforcement policy in a French general hospital intensive care unit (ICU), between 1994 and 1999. Design - In 1994, the number of methicillin-resistant Staphylococcus aureus (MRSA) strains responsible for infections and the incidence of imported or acquired MRSA colonized patients was simply observed. Later, specific interventions were successively performed: specific isolation of MRSA colonized patients, attempt to decontaminate these patients, and preventive specific isolation of an increasing number of hospitalized patients, before their colonization status was determined. Results - A significant decrease was observed in various rates: MRSA went from 54% to 13% (p < 0.05, hospital rate stable at 32%); the rate of patients with acquired MRSA infections went from 8.6% to 0% (p < 0.001); and the rate of patients with acquired colonization from 8.7% to 2.8% (NS for the overall 6 year analysis). Conclusions - This decrease was obtained through cooperation between ICU staff members, bacteriologists, and hospital nosocomial infection committee members. During the study, a particular attention was given to a strict application of the hand washing protocol. With a sustained effort, according to the Dutch model, these results may promote the possibility to control MRSA cross colonization in ICU patients in France, and the reduction of MRSA related infections. (C) 2002 Editions scientifiques et medicates Elsevier SAS.