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Long-Term Control of Endemic Hospital-Wide Methicillin-Resistant Staphylococcus aureus (MRSA): The Impact of Targeted Active Surveillance for MRSA in Patients and Healthcare Workers

 

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dc.creator Rodríguez-Baño, Jesús es
dc.creator García, Lola es
dc.creator Ramírez, Encarnación es
dc.creator Lupión Mendoza, Carmen es
dc.creator Muniain Ezcurra, Miguel Angel es
dc.creator Velasco Ramírez, María del Carmen es
dc.creator Gálvez-Acebal, Juan es
dc.creator Toro López, María Dolores del es
dc.creator B. Millán, Antonio es
dc.creator López Cerero, Lorena es
dc.creator Pascual Hernández, Álvaro es
dc.date.accessioned 2016-04-20T17:19:45Z
dc.date.available 2016-04-20T17:19:45Z
dc.date.issued 2010-08
dc.identifier.citation Rodríguez-Baño, J., García, L., Ramírez, E., Lupión Mendoza, C., Muniain Ezcurra, M.A., Velasco Ramírez, M.d.C.,...,Pascual Hernández, Á. (2010). Long-Term Control of Endemic Hospital-Wide Methicillin-Resistant Staphylococcus aureus (MRSA): The Impact of Targeted Active Surveillance for MRSA in Patients and Healthcare Workers.
dc.identifier.issn 0924-8579 es
dc.identifier.uri http://hdl.handle.net/11441/40206
dc.description.abstract To evaluate the long-term impact of successive interventions on rates of methicillin-resistant Staphylococcus aureus (MRSA) colonization or infection and MRSA bacteremia in an endemic hospital-wide situation. DESIGN:Quasi-experimental, interrupted time-series analysis. The impact of the interventions was analyzed by use of segmented regression. Representative MRSA isolates were typed by use of pulsed-field gel electrophoresis. SETTING:A 950-bed teaching hospital in Seville, Spain. PATIENTS:All patients admitted to the hospital during the period from 1995 through 2008. METHODS:Three successive interventions were studied: (1) contact precautions, with no active surveillance for MRSA; (2) targeted active surveillance for MRSA in patients and healthcare workers in specific wards, prioritized according to clinical epidemiology data; and (3) targeted active surveillance for MRSA in patients admitted from other medical centers. RESULTS:Neither the preintervention rate of MRSA colonization or infection (0.56 cases per 1,000 patient-days [95% confidence interval {CI}, 0.49-0.62 cases per 1,000 patient-days]) nor the slope for the rate of MRSA colonization or infection changed significantly after the first intervention. The rate decreased significantly to 0.28 cases per 1,000 patient-days (95% CI, 0.17-0.40 cases per 1,000 patient-days) after the second intervention and to 0.07 cases per 1,000 patient-days (95% CI, 0.06-0.08 cases per 1,000 patient-days) after the third intervention, and the rate remained at a similar level for 8 years. The MRSA bacteremia rate decreased by 80%, whereas the rate of bacteremia due to methicillin-susceptible S. aureus did not change. Eighty-three percent of the MRSA isolates identified were clonally related. All MRSA isolates obtained from healthcare workers were clonally related to those recovered from patients who were in their care. CONCLUSION:Our data indicate that long-term control of endemic MRSA is feasible in tertiary care centers. The use of targeted active surveillance for MRSA in patients and healthcare workers in specific wards (identified by means of analysis of clinical epidemiology data) and the use of decolonization were key to the success of the program. es
dc.format application/pdf es
dc.language.iso eng es
dc.publisher Cambridge University Press es
dc.rights Attribution-NonCommercial-NoDerivatives 4.0 Internacional *
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/ *
dc.subject Patients es
dc.subject Workers es
dc.subject Pacientes es
dc.subject Trabajadores es
dc.subject Methicillin-Resistant Staphylococcus aureus es
dc.subject Staphylococcus aureus Resistente a Meticilina es
dc.title Long-Term Control of Endemic Hospital-Wide Methicillin-Resistant Staphylococcus aureus (MRSA): The Impact of Targeted Active Surveillance for MRSA in Patients and Healthcare Workers es
dc.type info:eu-repo/semantics/article es
dc.type.version info:eu-repo/semantics/acceptedVersion es
dc.rights.accessrights info:eu-repo/semantics/openAccess es
dc.contributor.affiliation Universidad de Sevilla. Departamento de Medicina. es
dc.contributor.affiliation Universidad de Sevilla. Departamento de Microbiología es
dc.relation.publisherversion http://www.jstor.org/stable/10.1086/654003 es
dc.identifier.doi 10.1086/654003 es
idus.format.extent 11 p. es
dc.identifier.idus https://idus.us.es/xmlui/handle/11441/40206
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