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Article: Sequential introduction of single room isolation and hand hygiene campaign in the control of methicillin-resistant Staphylococcus aureus in intensive care unit

TitleSequential introduction of single room isolation and hand hygiene campaign in the control of methicillin-resistant Staphylococcus aureus in intensive care unit
Authors
Issue Date2010
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcinfectdis/
Citation
Bmc Infectious Diseases, 2010, v. 10 How to Cite?
AbstractBackground: After renovation of the adult intensive care unit (ICU) with installation of ten single rooms, an enhanced infection control program was conducted to control the spread of methicillin-resistant Staphylococcus aureus (MRSA) in our hospital.Methods: Since the ICU renovation, all patients colonized or infected with MRSA were nursed in single rooms with contact precautions. The incidence of MRSA infection in the ICU was monitored during 3 different phases: the baseline period (phase 1); after ICU renovation (phase 2) and after implementation of a hand hygiene campaign with alcohol-based hand rub (phase 3). Patients infected with extended spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella species were chosen as controls because they were managed in open cubicles with standard precautions.Results: Without a major change in bed occupancy rate, nursing workforce, or the protocol of environmental cleansing throughout the study period, a stepwise reduction in ICU onset nonbacteraemic MRSA infection was observed: from 3.54 (phase 1) to 2.26 (phase 2, p = 0.042) and 1.02 (phase 3, p = 0.006) per 1000-patient-days. ICU onset bacteraemic MRSA infection was significantly reduced from 1.94 (phase 1) to 0.9 (phase 2, p = 0.005) and 0.28 (phase 3, p = 0.021) per 1000-patient-days. Infection due to ESBL-producing organisms did not show a corresponding reduction. The usage density of broad-spectrum antibiotics and fluoroquinolones increased from phase 1 to 3. However a significant trend improvement of ICU onset MRSA infection by segmented regression analysis can only be demonstrated when comparison was made before and after the severe acute respiratory syndrome (SARS) epidemic. This suggests that the deaths of fellow healthcare workers from an occupational acquired infection had an overwhelming effect on their compliance with infection control measures.Conclusion: Provision of single room isolation facilities and promotion of hand hygiene practice are important. However compliance with infection control measures relies largely on a personal commitment, which may increase when personal safety is threatened. © 2010 Cheng et al; licensee BioMed Central Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/137429
ISSN
2015 Impact Factor: 2.69
2015 SCImago Journal Rankings: 1.510
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheng, VCCen_HK
dc.contributor.authorTai, JWMen_HK
dc.contributor.authorChan, WMen_HK
dc.contributor.authorLau, EHYen_HK
dc.contributor.authorChan, JFWen_HK
dc.contributor.authorTo, KKWen_HK
dc.contributor.authorLi, IWSen_HK
dc.contributor.authorHo, PLen_HK
dc.contributor.authorYuen, KYen_HK
dc.date.accessioned2011-08-26T14:24:51Z-
dc.date.available2011-08-26T14:24:51Z-
dc.date.issued2010en_HK
dc.identifier.citationBmc Infectious Diseases, 2010, v. 10en_HK
dc.identifier.issn1471-2334en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137429-
dc.description.abstractBackground: After renovation of the adult intensive care unit (ICU) with installation of ten single rooms, an enhanced infection control program was conducted to control the spread of methicillin-resistant Staphylococcus aureus (MRSA) in our hospital.Methods: Since the ICU renovation, all patients colonized or infected with MRSA were nursed in single rooms with contact precautions. The incidence of MRSA infection in the ICU was monitored during 3 different phases: the baseline period (phase 1); after ICU renovation (phase 2) and after implementation of a hand hygiene campaign with alcohol-based hand rub (phase 3). Patients infected with extended spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella species were chosen as controls because they were managed in open cubicles with standard precautions.Results: Without a major change in bed occupancy rate, nursing workforce, or the protocol of environmental cleansing throughout the study period, a stepwise reduction in ICU onset nonbacteraemic MRSA infection was observed: from 3.54 (phase 1) to 2.26 (phase 2, p = 0.042) and 1.02 (phase 3, p = 0.006) per 1000-patient-days. ICU onset bacteraemic MRSA infection was significantly reduced from 1.94 (phase 1) to 0.9 (phase 2, p = 0.005) and 0.28 (phase 3, p = 0.021) per 1000-patient-days. Infection due to ESBL-producing organisms did not show a corresponding reduction. The usage density of broad-spectrum antibiotics and fluoroquinolones increased from phase 1 to 3. However a significant trend improvement of ICU onset MRSA infection by segmented regression analysis can only be demonstrated when comparison was made before and after the severe acute respiratory syndrome (SARS) epidemic. This suggests that the deaths of fellow healthcare workers from an occupational acquired infection had an overwhelming effect on their compliance with infection control measures.Conclusion: Provision of single room isolation facilities and promotion of hand hygiene practice are important. However compliance with infection control measures relies largely on a personal commitment, which may increase when personal safety is threatened. © 2010 Cheng et al; licensee BioMed Central Ltd.en_HK
dc.languageengen_US
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcinfectdis/en_HK
dc.relation.ispartofBMC Infectious Diseasesen_HK
dc.rightsBMC Infectious Diseases. Copyright © BioMed Central Ltd.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshCross Infection - microbiology - prevention and control - transmission-
dc.subject.meshHandwashing - methods-
dc.subject.meshMethicillin-Resistant Staphylococcus aureus - isolation and purification-
dc.subject.meshPatient Isolation - methods-
dc.subject.meshStaphylococcal Infections - microbiology - prevention and control - transmission-
dc.titleSequential introduction of single room isolation and hand hygiene campaign in the control of methicillin-resistant Staphylococcus aureus in intensive care uniten_HK
dc.typeArticleen_HK
dc.identifier.emailLau, EHY: ehylau@hku.hken_HK
dc.identifier.emailChan, JFW: jfwchan@hku.hken_HK
dc.identifier.emailTo, KKW: kelvinto@hkucc.hku.hken_HK
dc.identifier.emailHo, PL: plho@hkucc.hku.hken_HK
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hken_HK
dc.identifier.authorityLau, EHY=rp01349en_HK
dc.identifier.authorityChan, JFW=rp01736en_HK
dc.identifier.authorityTo, KKW=rp01384en_HK
dc.identifier.authorityHo, PL=rp00406en_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/1471-2334-10-263en_HK
dc.identifier.pmid20822509-
dc.identifier.pmcidPMC2944349-
dc.identifier.scopuseid_2-s2.0-77956458074en_HK
dc.identifier.hkuros190828en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77956458074&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume10en_HK
dc.identifier.isiWOS:000283147200002-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridCheng, VCC=38662328400en_HK
dc.identifier.scopusauthoridTai, JWM=7101993154en_HK
dc.identifier.scopusauthoridChan, WM=36503669100en_HK
dc.identifier.scopusauthoridLau, EHY=7103086074en_HK
dc.identifier.scopusauthoridChan, JFW=24278817900en_HK
dc.identifier.scopusauthoridTo, KKW=14323807300en_HK
dc.identifier.scopusauthoridLi, IWS=24464179500en_HK
dc.identifier.scopusauthoridHo, PL=7402211363en_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK
dc.identifier.citeulike7967190-

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