56 SUCCESSFUL CONTROL OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS IN A UROLOGY WARD POSSIBLY DUE TO AVOIDANCE OF ANTIMICROBIAL PROPHYLAXIS IN MINIMALLY INVASIVE SURGERY: OUR 11 YEARS TRIAL

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes I1 Apr 201256 SUCCESSFUL CONTROL OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS IN A UROLOGY WARD POSSIBLY DUE TO AVOIDANCE OF ANTIMICROBIAL PROPHYLAXIS IN MINIMALLY INVASIVE SURGERY: OUR 11 YEARS TRIAL Manabu Tatokoro, Hitoshi Masuda, Toshiki Kijima, Soichiro Yoshida, Mizuaki Sakura, Minato Yokoyama, Kazutaka Saito, Fumitaka Koga, Yasuhisa Fujii, Satoru Kawakami, and Kazunori Kihara Manabu TatokoroManabu Tatokoro Tokyo, Japan More articles by this author , Hitoshi MasudaHitoshi Masuda Tokyo, Japan More articles by this author , Toshiki KijimaToshiki Kijima Tokyo, Japan More articles by this author , Soichiro YoshidaSoichiro Yoshida Tokyo, Japan More articles by this author , Mizuaki SakuraMizuaki Sakura Tokyo, Japan More articles by this author , Minato YokoyamaMinato Yokoyama Tokyo, Japan More articles by this author , Kazutaka SaitoKazutaka Saito Tokyo, Japan More articles by this author , Fumitaka KogaFumitaka Koga Tokyo, Japan More articles by this author , Yasuhisa FujiiYasuhisa Fujii Tokyo, Japan More articles by this author , Satoru KawakamiSatoru Kawakami Tokyo, Japan More articles by this author , and Kazunori KiharaKazunori Kihara Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.101AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES MRSA results in longer hospitalization, increased expenses, and poorer patient prognosis. The indiscriminate use of antibiotics has been identified as an important factor in the increasing dissemination of MRSA. Although most hospitals control the inappropriate use of antibiotics, the incidence of MRSA has continued to increase. To eradicate MRSA, since 2001 we have implemented a stepwise infection control strategy that includes an avoidance in antimicrobial prophylaxis (AMP) based on surgical wound classification. Elsewhere, we have reported that AMP could be gradually reduced in gasless single port urologic surgery without increasing surgical site infections (Int J Urol. 2007 and 2008). METHODS The study was conducted at a university hospital in central Tokyo. Until 2000, no active infection control program had been implemented. In 2001, we introduced a stepwise infection control strategy in the urology ward. In 2007, active surveillance for MRSA in all urological patients was commenced. MRSA was classified as ‘imported' when it was identified within 72 hrs of admission or if the patient was previously known to be an MRSA carrier, whereas it was classified as ‘acquired' when it was identified more than 72 hrs after admission. Clinically significant MRSA infection (CSMI) was defined as an MRSA infection associated with clinical symptoms. The incidence rate (IR), expressed as the annual number of cases per 1000 patient years, was calculated and the trend analysis was assessed using a Poisson regression. RESULTS Over the study period, 139,866 patients (pts), including 10,201 urology pts, were admitted to our Hospital. Of them, 3,719, including 134 urology pts, were diagnosed with MRSA. Although the IR of MRSA increased in the hospital, it decreased significantly in the urology ward (p < 0.01). Of the urology pts with MRSA, 33.6% were classified as ‘imported', and 66.4% were ‘acquired'. In the urology ward, the IR of acquired MRSA decreased significantly with time (p <0.01), although the IR of imported MRSA did not change. 69 CSMI were identified and the IR of CSMI decreased (p < 0.01). CONCLUSIONS Avoidance of AMP in minimally invasive surgery might contribute to reduction of hospital-acquired MRSA. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e24 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Manabu Tatokoro Tokyo, Japan More articles by this author Hitoshi Masuda Tokyo, Japan More articles by this author Toshiki Kijima Tokyo, Japan More articles by this author Soichiro Yoshida Tokyo, Japan More articles by this author Mizuaki Sakura Tokyo, Japan More articles by this author Minato Yokoyama Tokyo, Japan More articles by this author Kazutaka Saito Tokyo, Japan More articles by this author Fumitaka Koga Tokyo, Japan More articles by this author Yasuhisa Fujii Tokyo, Japan More articles by this author Satoru Kawakami Tokyo, Japan More articles by this author Kazunori Kihara Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...