Impact of active surveillance and contact isolation on transmission of methicillin-resistant Staphylococcus aureus in intensive care units in an area with high prevalence

J Formos Med Assoc. 2010 Apr;109(4):258-68. doi: 10.1016/S0929-6646(10)60051-4.

Abstract

Background/purpose: Previous research has suggested that active surveillance and early initiation of contact isolation (ASI) can control the nosocomial spread of methicillin-resistant Staphylococcus aureus (MRSA), especially among intensive care unit (ICU) patients. However, these interventions have never been implemented in Taiwan.

Methods: This study was conducted from September 2005 to October 2006 to evaluate the effect of ASI on the spread of MRSA in two medical centers in Taiwan with a high prevalence of MRSA. One ICU from each hospital was selected as a study site. In phase I (the first 6 months), only active surveillance was introduced. In phase II (the final 6 months), ASI for patients who had positive MRSA cultures was implemented.

Results: The incidence of acquiring MRSA during ICU stay did not differ significantly during phases I and II in hospital A (p = 0.940) and hospital B (p = 0.810). The independent risk factors for acquiring MRSA in the ICU were length of stay and presence of respiratory tract diseases.

Conclusion: This study demonstrated that, given the current resource limitations, ASI alone could not reduce MRSA transmission in two ICUs in Taiwan, where the MRSA prevalence was high.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control*
  • Female
  • Humans
  • Infection Control / methods
  • Intensive Care Units*
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Middle Aged
  • Population Surveillance / methods*
  • Prevalence
  • Program Evaluation
  • Risk Factors
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / prevention & control
  • Staphylococcal Infections / transmission*
  • Taiwan / epidemiology
  • Time Factors