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Reduction in the rate of methicillin-resistant Staphylococcus aureus acquisition in surgical wards by rapid screening for colonization: a prospective, cross-over study.

Hardy, Katherine and Price, Charlotte and Szczepura, Ala and Gossain, Savita and Davies, Ruth and Stallard, Nigel and Shabir, Sahida and McMurray, Claire and Bradbury, Andrew W and Hawkey, Peter M (2010) Reduction in the rate of methicillin-resistant Staphylococcus aureus acquisition in surgical wards by rapid screening for colonization: a prospective, cross-over study. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 16 (4). pp. 333-9. ISSN 1469-0691. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs

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Official URL: http://onlinelibrary.wiley.com/doi/10.1111/j.1469-...

Abstract

Identification of patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) and subsequent isolation and decolonization is pivotal to the control of cross infection in hospitals. The aim of this study was to establish if early identification of colonized patients using rapid methods alone reduces transmission. A prospective, cluster, two-period cross-over design was used. Seven surgical wards at a large hospital were allocated to two groups, and for the first 8 months four wards used rapid MRSA screening and three wards used a standard culture method. The groups were reversed for the second 8 months. Regardless of the method of detection, all patients were screened for nasal carriage on admission and then every 4 days. MRSA control measures remained constant. Results were analysed using a log linear Poisson regression model. A total of 12 682/13 952 patient ward episodes (PWE) were included in the study. Admission screening identified 453 (3.6%) MRSA-positive patient ward episodes, with a further 268 (2.2%) acquiring MRSA. After adjusting for other variables, rapid screening was shown to statistically reduce MRSA acquisition, with patients being 1.49 times (p 0.007) more likely to acquire MRSA in wards where they were screened using the culture method. Screening of surgical patients using rapid testing resulted in a statistically significant reduction in MRSA acquisition. This result was achieved in a routine surgical service with high bed occupancy and low availability of isolation rooms, making it applicable to the majority of health-care systems worldwide.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs
Subjects: WC Communicabable diseases
Divisions: Clinical Support > Infection Control
Clinical Support > Pathology
Planned IP Care > Vascular
Related URLs:
Depositing User: Preeti Puligari
Date Deposited: 28 Aug 2014 14:51
Last Modified: 28 Aug 2014 14:51
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/580

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