![[ Visit the Fifth Decennial online ]](images/banner.gif)
Objective: The aim of this study was to estimate the impact of ASC to control spread of MRSA in a CCU of a general hospital in Buenos Aires.
Methods: In an adult CCU with 16 beds, with medical and surgical patients, a before-after design study was conducted. Preintervention period: from May 1st 2004 to April 30th 2006 (24 months). Intervention period: May 1st 2006 to July 30th 2009 (39 months). Anterior nares and rectal swab samples were taken for culture at CCU admission in those patients with an expected stay of at least 48 hours. All patients were re-cultured weekly during their stay at the CCU stay to detect those who acquired the organism. Hand hygiene & isolation precautions were enhanced.
Results: Preintervention period: There were 600 admitted patients with 3201 patient-days. Nosocomial infection rate was 15.93‰. MRSA infection episodes were 24 with a MRSA infection rate of 7.5‰ (24/3201). A total of 138 strains of S. aureus, 46 MSSA and 92 MRSA (66.6%), were isolated. MRSA monthly isolation ratio was 3.8 (92/24)
Intervention period: There was a 12252 patient-days period. Of 2411 patients, 1208 (50%) were screened at admission and 2891 screening cultures were performed in the weekly follow up. 48/1208 (3.75%) patients were found as carriers at admission and 45 of the 1160 negative patients (4%) became positive during stay. There were 3599 patient-isolation days. Seven new infections 7/12252 (0.57‰) occurred: 3 ventilator-associated pneumonia and 4 bloodstream infection. MRSA monthly isolation ratio was 1.4 (55/39) Conclusions: The MRSA nosocomial infection rate in the unit was 0.57‰ compared to 7.5‰ patient-days in the pre-intervention period, p<0.001. The monthly isolation ratio decreased from 3.8 to 1.4. ASC and enhanced isolation precautions contributed to control MRSA spread.