2009 Southern Regional Meeting Abstracts

Purpose of Study: High rates of methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection among our intensive care unit (ICU) patients have been difficult and at best partially successful to control in spite of targeted isolation. We are reporting the effect of establishing an Infection control bundle on the rate of MRSA colonization and infection in a Community hospital ICU.
Methods Used: From 2001 to 2003, the incidence rate of MRSA colonization and infection was ranging from 2.5 per 1,000 patient-days to a peak of 3.71 by early 2004. In order to curb this increase and the subsequent associated mortality and morbidity, the infection control department aggressively instituted a bundle of precautionary measures that comprised (1) constant education, (2) audits, (3) isolation of known case with dedicated equipment, (4) hand hygiene, (5) preemptive use of gloves (5) preemptive use of gown if there is a known case of multi-drug resistant organism (MDRO), (6) decolonization. The data from the ICU 3 years post-implementation are reviewed to monitor the effect of the bundle.
Summary of Results: With implementation and active diffusion of the new guidelines, the response was immediate. In 2005, a nadir of 1.06/1,000 patient-years was achieved. By 2007, however, the incidence rate of MRSA colonization and infection has plateaued at 1.56/1,000 patient-years. All in all, the incidence of MRSA in the ICU has been at one of its lowest level since the introduction of the program. 36 months after the outbreak, this model continues to be accepted and practiced successfully by the ICU staff.
Conclusions: MRSA control programs can be effective in controlling an outbreak and maintaining a low incidence of nososcomial MRSA colonization and infection in the ICU population. Our study as many others is adding more evidence that a multipronged strategy may be necessary to control the rate of MRSA infection and colonization