Use of a temporary cohort ward as part of an intervention to reduce the incidence of meticillin-resistant Staphylococcus aureus in a vascular surgery ward

This article describes the effect of introducing a cohort area into a vascular surgery ward where a sustained increase in new cases of meticillin-resistant Staphylococcus aureus (MRSA) made the implementation of standard MRSA infection control precautions untenable. A recent review of published reports concluded, 'that Little evidence could be found to suggest that isolation measures recommended in the UK are effective'. The authors recommended a reporting format to enable the evidence for isolation to be gathered more systematically. This paper follows the recommended reporting format. The setting was a 30-bedded acute and subacute vascular surgery ward within a tertiary care hospital in Glasgow, UK. The data were analysed as an interrupted time series of 19 months pre-cohort, eight months with cohort and eight months post cohort. Following the instigation of the cohort area, there was a significant reduction in the number of nosocomial MRSA isolates from patients (P = 0.0005). This reduction was sustained after the cohort area was discontinued. In conclusion, effective separation of MRSA-colonized/-infected patients from patients who are not colonized/infected with MRSA, using a cohort area, resulted in a significant reduction in MRSA cross-colonization and cross-infection. The resulting reduction in MRSA prevalence within the unit facilitated effective screening and isolation of subsequent patients once the cohort area had been discontinued. (c) 2006 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.