The effect of targeted decolonization on methicillin-resistant Staphylococcus aureus colonization or infection in a surgical intensive care unit - 02/05/16
Highlights |
• | Decolonization using chlorhexidine baths and intranasal mupirocin helped reduce methicillin-resistant Staphylococcus aureus colonization or infection in a surgical intensive care unit. |
• | Mupirocin resistance and the presence of qacA/B genes, which are associated with chlorhexidine resistance, in Staphylococcus aureus was not uncommon. |
• | Low-level mupirocin resistance was significantly increased from 0% to 19% during a 40-month study period. |
Abstract |
Background |
The effect of decolonization on the control of methicillin-resistant Staphylococcus aureus (MRSA) may differ depending on intensive care unit (ICU) settings and the prevalence of antiseptic resistance in MRSA.
Methods |
This study was conducted in a 14-bed surgical ICU over a 40-month period. The baseline period featured active surveillance for MRSA and institution of contact precautions. MRSA decolonization via chlorhexidine baths and intranasal mupirocin was implemented during a subsequent 20-month intervention period. Pre–post and interrupted time series analysis were used to evaluate changes in the clinical incidence of hospital-acquired MRSA colonization or infection. MRSA isolates were tested for the presence of qacA/B genes and mupirocin resistance.
Results |
In pre–post analysis, the clinical incidence of MRSA significantly decreased by 61.6% after implementation of decolonization (P < .001). Meanwhile, interrupted time series analysis showed decreases in both the level (β = −0.686; P = .210) and trend (β = −0.011; P = .819) of clinical MRSA incidence, but these changes were not statistically significant. Of 169 MRSA isolates, 64 (37.8%) carried the qacA/B genes, and 22 (13.0%) showed either low- (n = 20) or high-level (n = 2) resistance to mupirocin. Low-level mupirocin resistance significantly increased from 0%-19.4% during the study period.
Conclusion |
Although decolonization using antiseptic agents was helpful to decrease hospital-acquired MRSA rates, the emergence of antiseptic resistance should be monitored.
Le texte complet de cet article est disponible en PDF.Key Words : Mupirocin, Chlorhexidine, Infection control
Plan
| This work was presented in part at ID week, Philadelphia, PA, October 8-12, 2014 (abstract No. 47277). |
|
| Funding sources: None. |
|
| Conflicts of Interest: None to report. |
Vol 44 - N° 5
P. 533-538 - mai 2016 Retour au numéro
Article précédent
- Asymptomatic rectal colonization with carbapenem-resistant Enterobacteriaceae and Clostridium difficile among residents of a long-term care facility in New York City
- Nishant Prasad, Georges Labaze, Joanna Kopacz, Sophie Chwa, Dimitris Platis, Cynthia X. Pan, Daniel Russo, Vincent J. LaBombardi, Giuliana Osorio, Simcha Pollack, Barry N. Kreiswirth, Liang Chen, Carl Urban, Sorana Segal-Maurer
- Risk of infection following colonization with carbapenem-resistant Enterobactericeae: A systematic review
- Jessica Tischendorf, Rafael Almeida de Avila, Nasia Safdar
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?