Long-term improvement of prevention of Methicillin –resistance Staphylococcus aureus in Bumrungrad International 2002-2008

Background: Methicillin–resistance Staphylococcus aureus are usually brought into a hospital by symptomatic and asymptomatic carrier either from patient or staff members. Since 1997 when Bumrungrad International has gained the reputation as a leading hospital for medical tourism, each year  up to 40% of our patients were foreigners. At the same time an increasing trend of Methicillin –resistance Staphylococcus aureus in referred cases have been outstanding

Objective: This project was to decrease Methicillin –resistance Staphylococcus aureus hospital acquired-infection rate equal to or below one from Institute for Health Care Improvement-Acute Care

Methods: To verify Methicillin–resistance Staphylococcus aureus status, multiple drug resistance organisms surveillance with root-cause analysis were developed. The quality improvement tools included plan-do-check-act cycle, cost effectiveness analysis, line listing system, critical unit then hospital wide preemptive isolation, out patient barrier protection alarming system, antibiogram, education program and benchmarking have been implemented since the project started in 2001

Results: While Bumrungrad International had been increasingly exposed to Methicillin–resistance Staphylococcus aureus reflected by elevated Methicillin –resistance Staphylococcus aureus attack rate during 2002-2008 as 0.6,1.4,1.7,1.8,1.9,2.02 and 2.73/ 1000 admissions the Methicillin –resistance Staphylococcus aureus infection had been kept low at all time as 0.05,0.1,0.07,0.12,0.05,0.1 and 0.08/1000 patient days. These were lower than Institute for Health Care Improvement-Acute Care since 2004 (0.95, 0.56 and 0.44). 

Conclusions: To control Methicillin–resistance Staphylococcus aureus spreading in the hospital additional measures such as preemptive isolation, line listing and alarming system, were effectively controlling Methicillin–resistance Staphylococcus aureus to the rate lower than Institute for Health Care Improvement-Acute Care.