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Article: Minimal intervention for controlling nosocomial transmission of Methicillin-Resistant Staphylococcus aureus in resource limited setting with high endemicity
Title | Minimal intervention for controlling nosocomial transmission of Methicillin-Resistant Staphylococcus aureus in resource limited setting with high endemicity |
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Authors | |
Issue Date | 2014 |
Publisher | Public Library of Science. The Journal's web site is located at http://www.plosone.org/home.action |
Citation | PLoS One, 2014, v. 9 n. 6, p. Article no. e100493 How to Cite? |
Abstract | Objective: To control nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in resource-limited healthcare setting with high endemicity. Methods: Three phases of infection control interventions were implemented in a University-affiliated hospital between 1- January-2004 and 31-December-2012. The first phase of baseline period, defined as the first 48-months of the study period, when all MRSA patients were managed with standard precautions, followed by a second phase of 24-months, when a hospital-wide hand hygiene campaign was launched. In the third phase of 36-months, contact precautions in open cubicle, use of dedicated medical items, and 2% chlorhexidine gluconate daily bathing for MRSA-positive patients were implemented while hand hygiene campaign was continued. The changes in the incidence rates of hospital-acquired MRSA-per- 1000-patient admissions, per-1000-patient-days, and per-1000-MRSA-positive-days were analyzed using segmented Poisson regression (an interrupted time series model). Usage density of broad-spectrum antibiotics was monitored. Results: During the study period, 4256 MRSA-positive patients were newly diagnosed, of which 1589 (37.3%) were hospitalacquired. The reduction of hospital-acquired MRSA per 1000-patient admissions, per 1000-patient-days, and per 1000- MRSA-positive-days from phase 1 to 2 was 36.3% (p<0.001), 30.4% (p<0.001), and 19.6% (p = 0.040), while the reduction of hospital-acquired MRSA per 1000-patient admissions, per 1000-patient-days, and per 1000-MRSA-positive-days from phase 2 to 3 was 27.4% (p<0.001), 24.1% (p<0.001), and 21.9% (p = 0.041) respectively. This reduction is sustained despite that the usage density of broad-spectrum antibiotics has increased from 132.02 (phase 1) to 168.99 per 1000 patient-days (phase 3). Conclusions: Nosocomial transmission of MRSA can be reduced with hand hygiene campaign, contact precautions in open cubicle, and 2% chlorhexidine gluconate daily bathing for MRSA-positive despite an increasing consumption of broadspectrum antibiotics. © 2014 Cheng et al. |
Persistent Identifier | http://hdl.handle.net/10722/200726 |
ISSN | 2023 Impact Factor: 2.9 2023 SCImago Journal Rankings: 0.839 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Cheng, VCC | - |
dc.contributor.author | Tai, JWM | - |
dc.contributor.author | Chau, PH | - |
dc.contributor.author | Chen, JHK | - |
dc.contributor.author | Yan, MK | - |
dc.contributor.author | So, SYC | - |
dc.contributor.author | To, KKW | - |
dc.contributor.author | Chan, JFW | - |
dc.contributor.author | Wong, SCY | - |
dc.contributor.author | Ho, PL | - |
dc.contributor.author | Yuen, KY | - |
dc.date.accessioned | 2014-08-21T06:58:00Z | - |
dc.date.available | 2014-08-21T06:58:00Z | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | PLoS One, 2014, v. 9 n. 6, p. Article no. e100493 | - |
dc.identifier.issn | 1932-6203 | - |
dc.identifier.uri | http://hdl.handle.net/10722/200726 | - |
dc.description.abstract | Objective: To control nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in resource-limited healthcare setting with high endemicity. Methods: Three phases of infection control interventions were implemented in a University-affiliated hospital between 1- January-2004 and 31-December-2012. The first phase of baseline period, defined as the first 48-months of the study period, when all MRSA patients were managed with standard precautions, followed by a second phase of 24-months, when a hospital-wide hand hygiene campaign was launched. In the third phase of 36-months, contact precautions in open cubicle, use of dedicated medical items, and 2% chlorhexidine gluconate daily bathing for MRSA-positive patients were implemented while hand hygiene campaign was continued. The changes in the incidence rates of hospital-acquired MRSA-per- 1000-patient admissions, per-1000-patient-days, and per-1000-MRSA-positive-days were analyzed using segmented Poisson regression (an interrupted time series model). Usage density of broad-spectrum antibiotics was monitored. Results: During the study period, 4256 MRSA-positive patients were newly diagnosed, of which 1589 (37.3%) were hospitalacquired. The reduction of hospital-acquired MRSA per 1000-patient admissions, per 1000-patient-days, and per 1000- MRSA-positive-days from phase 1 to 2 was 36.3% (p<0.001), 30.4% (p<0.001), and 19.6% (p = 0.040), while the reduction of hospital-acquired MRSA per 1000-patient admissions, per 1000-patient-days, and per 1000-MRSA-positive-days from phase 2 to 3 was 27.4% (p<0.001), 24.1% (p<0.001), and 21.9% (p = 0.041) respectively. This reduction is sustained despite that the usage density of broad-spectrum antibiotics has increased from 132.02 (phase 1) to 168.99 per 1000 patient-days (phase 3). Conclusions: Nosocomial transmission of MRSA can be reduced with hand hygiene campaign, contact precautions in open cubicle, and 2% chlorhexidine gluconate daily bathing for MRSA-positive despite an increasing consumption of broadspectrum antibiotics. © 2014 Cheng et al. | - |
dc.language | eng | - |
dc.publisher | Public Library of Science. The Journal's web site is located at http://www.plosone.org/home.action | - |
dc.relation.ispartof | PLoS ONE | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.title | Minimal intervention for controlling nosocomial transmission of Methicillin-Resistant Staphylococcus aureus in resource limited setting with high endemicity | - |
dc.type | Article | - |
dc.identifier.email | Cheng, VCC: vcccheng@hkucc.hku.hk | - |
dc.identifier.email | Chau, PH: phpchau@hku.hk | - |
dc.identifier.email | Chen, JHK: jonchk@hku.hk | - |
dc.identifier.email | To, KKW: kelvinto@hkucc.hku.hk | - |
dc.identifier.email | Chan, JFW: jfwchan@hku.hk | - |
dc.identifier.email | Wong, SCY: wcy288@hku.hk | - |
dc.identifier.email | Ho, PL: plho@hkucc.hku.hk | - |
dc.identifier.email | Yuen, KY: kyyuen@hkucc.hku.hk | - |
dc.identifier.authority | Chau, PH=rp00574 | - |
dc.identifier.authority | To, KKW=rp01384 | - |
dc.identifier.authority | Chan, JFW=rp01736 | - |
dc.identifier.authority | Ho, PL=rp00406 | - |
dc.identifier.authority | Yuen, KY=rp00366 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1371/journal.pone.0100493 | - |
dc.identifier.pmid | 24945412 | - |
dc.identifier.pmcid | PMC4063951 | - |
dc.identifier.scopus | eid_2-s2.0-84903184417 | - |
dc.identifier.hkuros | 232452 | - |
dc.identifier.volume | 9 | - |
dc.identifier.issue | 6 | - |
dc.identifier.spage | Article no. e100493 | - |
dc.identifier.epage | Article no. e100493 | - |
dc.identifier.isi | WOS:000340721500081 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 1932-6203 | - |