Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-15T04:06:44.311Z Has data issue: false hasContentIssue false

The Best Hospital Practices for Controlling Methicillin-Resistant Staphylococcus Aureus: On the Cutting Edge

Published online by Cambridge University Press:  02 January 2015

Meredith S. Arnold
Affiliation:
Kent Hospital, Warwick, Rhode Island
Jane M. Dempsey
Affiliation:
Rhode Island Hospital, Providence, Rhode Island
Marlene Fishman*
Affiliation:
St. Joseph Health Services of Rhode Island, North Providence, Rhode Island
Patricia J. McAuley
Affiliation:
Kent Hospital, Warwick, Rhode Island
Cynthia Tibert
Affiliation:
Veterans' Administration Hospital, Providence, Rhode Island
Nancy C. Vallande
Affiliation:
Miriam Hospital, Providence, Rhode Island
*
Marian Hall, First Floor, Our Lady of Fatima Hospital, 200 High Service Avenue, North Providence, RI 02904

Abstract

Objective:

A performance improvement task force of Rhode Island infection control professionals was created to develop an epidemiologic model of statewide consistent infection control practices that could reduce the spread of methicillin-resistant Staphylococcus aureus (MRSA).

Design:

This model encompasses screening protocols, isolation techniques, methods of cohorting positive patients, decolonization issues, postexposure follow-up, microbiology procedures, and standardized surveillance methodologies. These “best practice guidelines” include three categories of recommendations that define priority levels based on the availability of scientific data.

Setting:

From 1995 through 2000, several Rhode Island hospitals experienced a fivefold increase in nosocomial acquisition of MRSA.

Participants:

Rhode Island infection control professionals are a highly interactive group in the unique position of sharing patients and ultimately experiencing similar trends and problems.

Intervention:

The task force collaborated on developing the best hospital infection control practices to prevent and control the spread of MRSA in Rhode Island.

Results:

The task force met with local infectious disease physicians and representatives from the Rhode Island Department of Health, the Hospital Association of Rhode Island, and Rhode Island Quality Improvement Partners. Discussions identified numerous and diverse MRSA control practices, issues of consensus, and approaches to resolving controversial methods of reducing the spread of MRSA The guidelines regarding the best hospital practices for controlling MRSA were finalized 8 months later.

Conclusion:

These guidelines were distributed to all chief executive officers of Rhode Island hospitals by the Rhode Island Department of Health in December 2001. They were issued separate and apart from any regulations, with the intent that hospitals will adopt them as best hospital practices in an attempt to control MRSA.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Boyce, JM, Jackson, MM, Pugliese, G, et al. Methicillin resistant Staphylococcus aureus (MRSA): a briefing for acute care hospitals and nursing facilities. Infect Control Hosp Epidemiol 1994;15:105115.Google Scholar
2.Kim, T, Oh, PI, Simor, AE. The economic impact of methicillin-resistant Staphylococcus aureus in Canadian hospitals. Infect Control Hosp Epidemiol 2001;22:99104.Google Scholar
3.Centers for Disease Control and Prevention, Food and Drug Administration, National Institutes of Health, et al. A Public Health Action Plan to Combat Antimicrobial Resistance: Part I. Domestic Issues. February 28, 2001. Available at www.cdc.gov/drugresistance/actionplan.Google Scholar
4.Warshawsky, B, Hussain, Z, Gregson, DB, et al. Hospital and community-based surveillance of methicillin-resistant Staphylococcus aureus: previous hospitalization is the major risk factor. Infect Control Hosp Epidemiol 2000;21:724727.CrossRefGoogle ScholarPubMed
5.Barakate, MS, Yang, YX, Foo, SH, et al. An epidemiological survey of methicillin-resistant Staphylococcus aureus in a tertiary referral hospital. J Hosp Infect 2000;44:1926.Google Scholar
6.Diekama, J. A losing battle: MRSA epidemic in U.S. hospitals. Hospital Infection Control 2001;28:7778.Google Scholar
7.Scanvic, A, Denic, L, Gaillon, S, Giry, P, Andremont, A, Lucet, JC. Duration of colonization by methicillin-resistant Staphylococcus aureus after hospital discharge and risk factors for prolonged carriage. Clin Infect Dis 2001;32:13931398.CrossRefGoogle ScholarPubMed
8.Ayliffe, GA, Buckles, A, Casewell, MW, et al. Revised guidelines for the control of methicillin-resistant Staphylococcus aureus infection in hospitals. J Hosp Infect 1998;39:253290.CrossRefGoogle Scholar
9.Calfee, DP, Giannetta, ET, Durbin, LJ, Farr, BM. MRSA and VRE prevalence among patients being transferred from primary and secondary care facilities. Am J Infect Control 2000;28:84. Abstract.Google Scholar
10.Chaix, C, Durand-Zaleski, I, Alberti, C, Brun-Buisson, C. Control of endemic methicillin-resistant Staphylococcus aureus: a cost benefit analysis in an intensive care unit. JAMA 1999;282:17451751.Google Scholar
11.Merrer, J, Santoli, F, Appere-DeVecchi, C, Tran, B, Dejonghe, B, Outin, H. “Colonization pressure” and risk of acquisition of methicillin-resistant Staphylococcus aureus in a medical intensive care unit. Infect Control Hosp Epidemiol 2000;21:718723.Google Scholar
12.Price, MF, Carlini, M, Houston, S, Gentry, LO. Prevalence of nasal colonization with methicillin-resistant Staphylococcus aureus in selected patient populations. Infect Control Hosp Epidemiol 2000;21:603605.Google Scholar
13.Papia, G, Louie, M, Tralla, A, Johnson, C, Collins, V, Simor, AE. Screening high risk patients for methicillin-resistant Staphylococcus aureus on admission to the hospital: is it cost effective? Infect Control Hosp Epidemiol 1999;20:473477.CrossRefGoogle Scholar
14.Troillet, N, Carmeli, Y, Samore, M, et al. Carriage of methicillin-resistant Staphylococcus aureus at hospital admission. Infect Control Hosp Epidemiol 1998;19:181185.Google Scholar
15.Rubinovitch, B, Pittet, D. Screening for methicillin-resistant Staphylococcus aureus in the endemic hospital: what have we learned? J Hosp Infect 2001;47:918.Google Scholar
16.Dancer, SJ, Crawford, A. Keeping MRSA out of a district general hospital. J Hosp Infect 1999;43(suppl):S19S27.Google Scholar
17.Suh, K, Toye, B, Jessamine, P, Chan, F, Ramotar, K. Epidemiology of methicillin-resistant Staphylococcus aureus in three Canadian tertiary-care centers. Infect Control Hosp Epidemiol 1998;19:395400.Google Scholar
18.Hospital Infection Control Advisory Committee (HICPAC). MRSA Information for Healthcare Personnel. August 27, 1999. Available at www.cdc.gov/ncidod/hip/aresist/mrsahcw.htm.Google Scholar
19.Guilhermetti, M, Hernandes, SED, Fukushigue, Y, Garcia, LB, Cardoso, CL. Effectiveness of hand-cleansing agents for removing methicillin-resistant Staphylococcus aureus from contaminated hands. Infect Control Hosp Epidemiol 2001;22:105108.Google Scholar
20.Weinstein, RA. Controlling antimicrobial resistance in hospitals: infection control and use of antibiotics. Emerg Infect Dis 2001;7:188192.Google Scholar
21.Lacey, S, Flaxman, D, Scales, J, Wilson, A. The usefulness of masks in preventing transient carriage of epidemic methicillin-resistant Staphylococcus aureus by healthcare workers. J Hosp Infect 2001;48:308311.Google Scholar
22.Herwaldt, LA. Control of methicillin-resistant Staphylococcus aureus in the hospital setting. Am J Med 1999;106(5A):11S18S.CrossRefGoogle ScholarPubMed
23.Hartstein, AI, LeMonte, AM, Iwamoto, PKL. DNA typing and control of methicillin-resistant Staphylococcus aureus at two affiliated hospitals. Infect Control Hosp Epidemiol 1997;18:4248.Google Scholar
24.Archer, GL, Climo, MW. Staphylococcus aureus bacteremia: consider the source. N Engl J Med 2001;344:5556.Google Scholar
25.Fung, S, O'Grady, S, Kennedy, C, Dedier, H, Campbell, I, Conly, J. The utility of polysporin ointment in the eradication of methicillin-resistant Staphylococcus aureus colonization: a pilot study. Infect Control Hosp Epidemiol 2000;21:653655.CrossRefGoogle ScholarPubMed
26.Sakoulis, G, Degirolami, P, Gold, HS. Methicillin susceptible Staphylococcus aureus: believe it or not. Arch Intern Med 2001;161:12371238.Google Scholar
27.von Eiff, C, Becker, K, Machka, K, Stammer, H, Peters, G. Nasal carriage as a source of Staphylococcus aureus bacteremia. N Engl J Med 2001;344:1116.CrossRefGoogle ScholarPubMed
28.Chambers, HF. The changing epidemiology of Staphylococcus aureus? Emerg Infect Dis 2001;7:178182.Google Scholar
29.Harstein, AI. Improved understanding and control of nosocomial methicillin-resistant Staphylococcus aureus: are we overdoing it? Infect Control Hosp Epidemiol 1995;16:257259.Google Scholar
30.Schentag, JJ, Hyatt, JM, Carr, JR, et al. Genesis of methicillin-resistant Staphylococcus aureus (MRSA), how treatment of MRSA infections has selected for vancomycin-resistant Enterococcus faecium, and the importance of antibiotic management and infection control. Clin Infect Dis 1998;26:12041214.CrossRefGoogle ScholarPubMed
31.Zhiming, L, Willke, RJ, Rittenhouse, BE, et al. Comparison of length of hospital stay for patients with known or suspected methicillin-resistant Staphylococcus species infections treated with linezolid or vancomycin: a randomized, multicenter trial. Pharmacotherapy 2001;21:263274.Google Scholar
32.Richet, HM, Mohammed, J, McDonald, LC, Jarvis, WR. Building communication networks: international network for the study and prevention of emerging antimicrobial resistance (INSPEAR). Emerg Infect Dis 2001;7:319322.CrossRefGoogle Scholar
33.Fridkin, SK. Vancomycin-intermediate and resistant Staphylococcus aureus: what the infectious disease specialist needs to know. Clin Infect Dis 2001;32:108115.Google Scholar
34.Kak, V, Levine, DP. Editorial response: community-acquired methicillin-resistant Staphylococcus aureus infections: where do we go from here? Clin Infect Dis 1999;29:801802.Google Scholar
35.Gorak, EJ, Yamada, SM, Brown, JD. Community-acquired methicillin-resistant Staphylococcus aureus in hospitalized adults and children without known risk factors. Clin Infect Dis 1999;29:797800.Google Scholar
36.Sanford, MD, Widmer, AF, Bale, MJ, Jones, RN, Wenzel, RP. Efficient detection and long-term persistence of the carriage of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 1994;19:11231128.Google Scholar
37.GlaxoSmithKline, . Current topics on methicillin-resistant Staphylococcus aureus infections and treatment. Staph News 2001;8:17.Google Scholar
38.Fluornoy, DJ. Methicillin-resistant Staphylococcus aureus at a Veterans Affairs Medical Center (1986-96). J Okla State Med Assoc 1997;90:228235.Google Scholar
39.Harbarth, S, Liassine, N, Dharan, S, Herrault, P, Aukenthaler, R, Pitter, D. Risk factors for persistent carriage of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 2000;31:13801385.Google Scholar