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Universal vs Risk Factor Screening for Methicillin-Resistant Staphylococcus aureus in a Large Multicenter Tertiary Care Facility in Canada

Published online by Cambridge University Press:  16 October 2015

V. R. Roth ,
T. Longpre ,
M. Taljaard ,
D. Coyle ,
K. N. Suh ,
K. A. Muldoon ,
K. Ramotar  and
A. Forster
V. R. Roth*
Affiliation:
Department of Medicine, the Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
T. Longpre
Affiliation:
Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
M. Taljaard
Affiliation:
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
D. Coyle
Affiliation:
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
K. N. Suh
Affiliation:
Department of Medicine, the Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
K. A. Muldoon
Affiliation:
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
K. Ramotar
Affiliation:
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Department of Pathology and Laboratory Medicine, Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
A. Forster
Affiliation:
Department of Medicine, the Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
*
Address correspondence to V. R. Roth, MD, Ottawa Hospital, Division of Infectious Diseases, 501 Smyth Rd, Ottawa, ON. K1H 8L6 ([email protected]).
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Abstract

OBJECTIVE

To assess the clinical effectiveness of a universal screening program compared with a risk factor–based program in reducing the rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) among admitted patients at the Ottawa Hospital.

DESIGN

Quasi-experimental study.

SETTING

Ottawa Hospital, a multicenter tertiary care facility with 3 main campuses, approximately 47,000 admissions per year, and 1,200 beds.

METHODS

From January 1, 2006 through December 31, 2007 (24 months), admitted patients underwent risk factor–based MRSA screening. From January 1, 2008 through August 31, 2009 (20 months), all patients admitted underwent universal MRSA screening. To measure the effectiveness of this intervention, segmented regression modeling was used to examine monthly nosocomial MRSA incidence rates per 100,000 patient-days before and during the intervention period. To assess secular trends, nosocomial Clostridium difficile infection, mupirocin prescriptions, and regional MRSA rates were investigated as controls.

RESULTS

The nosocomial MRSA incidence rate was 46.79 cases per 100,000 patient-days, with no significant differences before and after intervention. The MRSA detection rate per 1,000 admissions increased from 9.8 during risk factor–based screening to 26.2 during universal screening. A total of 644 new nosocomial MRSA cases were observed in 1,448,488 patient-days, 323 during risk factor–based screening and 321 during universal screening. Secular trends in C. difficile infection rates and mupirocin prescriptions remained stable after the intervention whereas population-level MRSA rates decreased.

CONCLUSION

At Ottawa Hospital, the introduction of universal MRSA admission screening did not significantly affect the rates of nosocomial MRSA compared with risk factor–based screening.

Infect. Control Hosp. Epidemiol. 2015;37(1):41–48

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 1 , January 2016 , pp. 41 - 48
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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