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Control of Methicillin-Resistant Staphylococcus aureus at a University Hospital: One Decade Later

Published online by Cambridge University Press:  02 January 2015

John A. Jernigan ,
Mark A. Clemence ,
Geraldine A. Stott ,
Maureen G. Titus ,
Carolyn H. Alexander ,
Carol M. Palumbo  and
Barry M. Farr
John A. Jernigan
Affiliation:
University of Virginia Health Sciences Center, Charlottesville, Virginia
Mark A. Clemence
Affiliation:
University of Virginia Health Sciences Center, Charlottesville, Virginia
Geraldine A. Stott
Affiliation:
University of Virginia Health Sciences Center, Charlottesville, Virginia
Maureen G. Titus
Affiliation:
University of Virginia Health Sciences Center, Charlottesville, Virginia
Carolyn H. Alexander
Affiliation:
University of Virginia Health Sciences Center, Charlottesville, Virginia
Carol M. Palumbo
Affiliation:
University of Virginia Health Sciences Center, Charlottesville, Virginia
Barry M. Farr*
Affiliation:
University of Virginia Health Sciences Center, Charlottesville, Virginia
*
University of Virginia, Health Sciences Center, Box 473, Charlottesville, VA 22908
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Abstract

Objective:

To investigate the cause of increasing rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection at a university hospital.

Design:

Review of data collected by prospective hospitalwide surveillance regarding rates of nosocomial MRSA colonization and infection.

Setting:

A 700-bed university hospital providing primary and tertiary care.

Patients:

Patients admitted to the hospital between 1986 and 1993 who were found to be infected or colonized with MRSA.

Main Outcome Measurement:

Rates of MRSA infection and colonization.

Results:

MRSA infection or colonization was identified in 399 patients (0.18%) admitted during the 8-year study. There was no correlation between the annual rates of MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) infections (P=.66). The frequency of both nosocomial and non-nosocomial cases increased significantly over the last 4 years of the study (P<.001 for trend). The ratio of patients who had acquired MRSA nosocomially to those admitted who already were infected or colonized decreased significantly during the study period (P=.002 for trend). There was a significant increase in the frequency of patients with MRSA being transferred from nursing homes and other chronic care facilities (P=.011). A cost-benefit analysis suggested that surveillance cultures of patients transferred from other healthcare facilities would save between $20,062 and $462,067 and prevent from 8 to 41 nosocomial infections.

Conclusions:

An increase in the incidence of nosocomial MRSA infection was associated with an increased frequency of transfer of colonized patients from nursing homes and other hospitals. The lack of correlation between rates of MRSA and MSSA infections suggested that MRSA infections significantly increased the overall rate of staphylococcal infection. Screening cultures of transfer patients from facilities with a high prevalence of MRSA may offer significant benefit by preventing nosocomial infections and reducing patient days spent in isolation.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 16 , Issue 12 , December 1995 , pp. 686 - 696
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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