ArticleThe Journal of hospital infection2013
Sustained meticillin-resistant Staphylococcus aureus control in a hyper-endemic tertiary acute care hospital with infrastructure challenges in Singapore.
Article in The Journal of hospital infection, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A systematic review of the effectiveness of cohorting to reduce transmission of healthcare-associatedInfection control and hospital epidemiology · 2020Pooled it
- Interventions to improve hand hygiene compliance in patient care.The Cochrane database of systematic reviews · 2017Pooled it
- Article
- Evaluating infection prevention and control programs in Austrian acute care hospitals using the WHO Infection Prevention and Control Assessment Framework.Antimicrobial resistance and infection control · 2020Article
- The epidemiology and transmission of methicillin-resistant Staphylococcus aureus in the community in Singapore: study protocol for a longitudinal household study.BMC infectious diseases · 2017Article
- Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations.Antimicrobial resistance and infection control · 2017Article
- Antiseptic Body Washes for Reducing the Transmission of Methicillin-Resistant Staphylococcus aureus: A Cluster Crossover Study.Open forum infectious diseases · 2015Article
- Article
- The effect of improved hand hygiene on nosocomial MRSA control.Antimicrobial resistance and infection control · 2014Review
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10 authors.
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Abstract
backgroundMeticillin-resistant Staphylococcus aureus (MRSA) has been entrenched in Singapore hospitals since the 1980s, with an excess of 600 non-duplicate cases of infections (120 bacteraemia episodes) each year in our 995-bed university hospital. Approximately 5% of our hospital beds are used as isolation facilities.
aimTo study the impact of an MRSA control bundle that was implemented via gradual geographic extension across hospital wards.
methodsThe bundle included active surveillance on admission and transfer/discharge to identify ward-based acquisition of MRSA, isolation and cohorting of MRSA-infected patients, enhanced hand hygiene initiatives, and publicly displayed feedback of MRSA acquisition and hand hygiene compliance rates. Implementation was between October 2006 and June 2010 in order to provide lead-time for the incremental development of infrastructural capacity, and to develop an ethic of infection prevention among staff. Results were analysed via interrupted time-series analysis.
findingsMRSA infections fell midway through the implementation, with MRSA bacteraemia declining from 0.26 [95% confidence interval (CI): 0.18-0.34] cases per 1000 inpatient-days in the first quarter of 2004 to 0.11 (95% CI: 0.07-0.19) cases per 1000 inpatient-days in the first quarter of 2012. MRSA acquisition rates fell a year after the programme had been fully implemented, whereas hand hygiene compliance rose significantly from 47% (95% CI: 44-49) in the first quarter of 2009 to 69% (95% CI: 68-71) in the first quarter of 2012.
conclusionSuccessful staged implementation of an MRSA bundle in a hyper-endemic setting is sustainable and represents a model that may be adapted for similar settings.
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