Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-14T04:35:37.419Z Has data issue: false hasContentIssue false
  • English
  • Français

To Isolate or Not to Isolate? Analysis of Data From the German Nosocomial Infection Surveillance System Regarding the Placement of Patients With Methicillin-Resistant Staphylococcus aureus in Private Rooms in Intensive Care Units

Published online by Cambridge University Press:  02 January 2015

Petra Gastmeier ,
Frank Schwab ,
Christine Geffers  and
Henning Rüden
Petra Gastmeier*
Affiliation:
Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany
Frank Schwab
Affiliation:
Institute of Hygiene, Free University Berlin, Berlin, Germany
Christine Geffers
Affiliation:
Institute of Hygiene, Free University Berlin, Berlin, Germany
Henning Rüden
Affiliation:
Institute of Hygiene, Free University Berlin, Berlin, Germany
*
Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Carl-Neuberg-Str. 1, 30 625 Hannover, Germany
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To investigate whether isolating patients with MRSA in private rooms in ICUs (or cohorting) is a protective factor for nosocomial MRSA infection.

Design:

Association between nosocomial MRSA infection rates and ICU structure and process parameters in the German Nosocomial Infection Surveillance System (KISS).

Setting:

Two hundred twelve ICUs participating in KISS in 2001.

Methods:

In June 2001, a structured questionnaire was sent to the participating ICUs regarding their preventive measures, their type and size, their patient-to-personnel ratios, and routine cultures. Univariate and multivariate analyses were conducted to identify risk factors for nosocomial MRSA infection.

Results:

The questionnaire was completed by 164 (77.4%) of the ICUs. These ICUs had 325 nosocomial MRSA infections in a 5-year period (1997 to 2001). The mean incidence density of nosocomial MRSA infections was 0.3/1,000 patient-days. Ninety-one ICUs (55.5%) did not register any nosocomial MRSA infections during the observation period. Forty-two ICUs had an incidence density of at least 0.3/1,000 patient-days (75th percentile). Surgical ICUs were found to be a risk factor for a nosocomial MRSA infection rate above this threshold. Multivariate analysis found surgical ICUs to be an independent predictor and isolation in private rooms (or cohorts) to be a protective factor (OR, 0.36; CI95, 0.17-0.79).

Conclusion:

Many (34.4%) of the German ICUs have not isolated MRSA patients in private rooms or cohorts, a procedure associated with lower MRSA infection rates in this study.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 2 , February 2004 , pp. 109 - 113
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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.Anonymous. Empfehlungen zur Pravention und Kontrolle von Methicillin-reistenten Methicillin-resistenten Staphylococcus aureus: Stammen (MRSA) in Krankenhäusen und anderen medizinischen Einrichtungen. Bundesgesundhbl 1999;42:954–958.Google Scholar
2.Gastmeier, P, Geffers, C, Sohr, D, Dettenkofer, M, Daschner, F, Rüden, H. Five years working with the German nosocomial infection surveillance System. Am J Infect Control 2003;31:316–321.CrossRefGoogle ScholarPubMed
3.Gastmeier, P, Sohr, D, Geffers, C, Nassauer, A, Daschner, F, Rüden, H. Are nosocomial infection rates in intensive care units benchmark parameters? Infection 2000;28:346–350.CrossRefGoogle ScholarPubMed
4.Emori, TG, Culver, DH, Horan, TC, et al.National Nosocomial Infection Surveillance (NNIS) System: description of surveillance methodology. Am J Infect Control 1991;19:19–35.Google Scholar
5.Garner, JS, Emori, WR, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988;16:128–140.CrossRefGoogle ScholarPubMed
6.Horan, TC, Gaynes, RP, Martone, WJ, Jarvis, WR, Emori, TG. CDC definitions of surgical site infections: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606–608.CrossRefGoogle ScholarPubMed
7.Gastmeier, P, Sohr, D, Just, H-M, Nassauer, A, Daschner, F, Rüden, H. How to survey nosocomial infections? Infect Control Hosp Epidemiol 2000;21:366–370.Google Scholar
8.Centers for Disease Control and Prevention. Methicillin-Resistant Staphylococcus aureus: Facts For Healthcare Workers. Atlanta, GA: Centers for Disease Control and Prevention; 2002. Available at www.cdc.gov/ncidod/hip/Aresist/mrsahcw.htm.Google Scholar
9.British Society for Antimicrobial Chemotherapy, Hospital Infection Society, Infection Control Nurses Association. Revised guidelines for the control of methicillin-resistant Staphylococcus aureus infection in hospitals. J Hosp Infect 1998;39:253–290.CrossRefGoogle Scholar
10.Edmond, M. Isolation. Infect Control Hosp Epidemiol 1997;18:58–64.Google Scholar
11.Barrett, S, Mummery, R, Cattopadhyay, B. Trying to control MRSA causes more problems than it solves. J Hosp Infect 1998;39:85–93.Google Scholar
12.Lepelletier, D, Richet, H. Surveillance and control of methicillin-resistant Staphylococcus aureus in French hospitals. Infect Control Hosp Epidemiol 2001;22:677–682.Google Scholar
13.Vidal-Trecam, G, Delamare, N, Tcherny-Lessenot, S, et al.Multidrug-resistant bacteria infection control: study of compliance with isolation precautions in a Paris university hospital. Infect Control Hosp Epidemiol 2001;22:109–111.CrossRefGoogle Scholar
14.Gastmeier, P, Sohr, D, Geffers, C, Nassauer, A, Dettenkofer, M. Occurrence of MRSA infections in German intensive care units. Infection 2002;30:198–202.CrossRefGoogle ScholarPubMed
15.National Nosocomial Infections Surveillance (NNIS) System. National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1992-June 2001, issued August 2001. Am J Infect Control 2001;29:404–421.Google Scholar
16.Haley, R, Cushion, N, Tenover, F, et al.Eradication of endemie methicillin-resistant Staphylococcus aureus infections from a neonatal intensive care unit. J Infect Dis 1995;171:614–624.CrossRefGoogle Scholar
17.Jernigan, J, Titus, M, Groschel, D, Getchell-White, S, Farr, B. Effectiveness of contact isolation during a hospital outbreak of methicillin-resistant Staphylococcus aureus. Am J Epidemiol 1996;143:496–504.Google Scholar