Abstract
Hospital-wide active surveillance for methicillin-resistant Staphylococcus aureus (MRSA) targeted to adult patients with a history of MRSA carriage within the past 5 years was performed in Juntendo University Hospital (JUH) over a 2-year period. In the first year, MRSA screening culture was ordered by physicians in charge. In the second year, infection-control practitioners (ICPs) took samples for active surveillance culture. The average monthly transmission rate of MRSA in JUH was 0.35 per 1,000 bed-days in the first year and decreased significantly to 0.26 per 1,000 bed-days in the second year (P < 0.05). In the second year, more active commitment of ICPs to MRSA screening was effective in improving the performance rate of screening, shortening turn-around time of screening results, and decreasing transmission rate. Increasing compliance with active MRSA surveillance by involvement of ICPs, targeting patients with a previous history of MRSA carriage in the previous 5 years, was effective to control nosocomial MRSA transmission.
Highlights
Since its discovery in 1961 [1], methicillin-resistant Staphylococcus aureus (MRSA) has remained a major nosocomial pathogen throughout the world, causing grave clinical and financial problems in healthcare facilities [2]
Hospital-wide active surveillance for methicillin-resistant Staphylococcus aureus (MRSA) targeted to adult patients with a history of MRSA carriage within the past 5 years was performed in Juntendo University Hospital (JUH) over a 2-year period
Active surveillance culture (AS-C) for MRSA has been conducted in Juntendo University Hospital (JUH) since 2006 for hospitalized patients having a history of MRSA carriage in the past 5 years
Summary
Since its discovery in 1961 [1], methicillin-resistant Staphylococcus aureus (MRSA) has remained a major nosocomial pathogen throughout the world, causing grave clinical and financial problems in healthcare facilities [2]. Active surveillance culture (AS-C) for MRSA has been conducted in Juntendo University Hospital (JUH) since 2006 for hospitalized patients having a history of MRSA carriage in the past 5 years. While waiting for the results of screening culture, healthcare workers (HCWs) followed a pre-emptive contact precaution policy, but the efficacy of this policy has not been evaluated. We postulated that a shorter turnaround time (TAT) of screening results could be expected by more active involvement of infection-control practitioners (ICPs) and shorter TAT might cause higher compliance to implement the contact precaution policy and to reduce nosocomial transmission of MRSA. We analyzed the effect of our active surveillance practice on the rate of horizontal MRSA transmission in the hospital, especially of the commitment of ICPs to active MRSA screening
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