ArticleBMJ open2013
Comparison of strategies to reduce meticillin-resistant Staphylococcus aureus rates in surgical patients: a controlled multicentre intervention trial.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00685867 (An Interventional Study to Evaluate the Impact of Two Innovative Strategies in Preventing Nosocomial MRSA Infection in Surgical Patients), which is not on this map. Cited by 27 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
An Interventional Study to Evaluate the Impact of Two Innovative Strategies in Preventing Nosocomial MRSA Infection in Surgical Patients
Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Interventions to improve hand hygiene compliance in patient care.The Cochrane database of systematic reviews · 2017Pooled it
- Infection Risk in Sterile Operative Procedures.Deutsches Arzteblatt international · 2016Pooled it
- Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2015Pooled it
- Preoperative skin antiseptics for preventing surgical wound infections after clean surgery.The Cochrane database of systematic reviews · 2015Pooled it
- Methicillin-resistant Staphylococcus aureus.Nature reviews. Disease primers · 2026Review
- Universal decolonization for methicillin-resistantPublic health in practice (Oxford, England) · 2026Article
- Clonal distribution and molecular characterization ofMedicine and pharmacy reports · 2024Article
- Associations between negative patient safety climate and infection prevention practices.American journal of infection control · 2024Article
- Postoperative Staphylococcus aureus Infections in Patients With and Without Preoperative Colonization.JAMA network open · 2023Article
- Impact of patient safety climate on infection prevention practices and healthcare worker and patient outcomes.American journal of infection control · 2023Observational
- Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update.Infection control and hospital epidemiology · 2023Article
- Effectiveness of Extended Infection Control Measures on Methicillin-ResistantIndian journal of orthopaedics · 2022Article
- Surgical Antibiotic Prophylaxis in an Era of Antibiotic Resistance: Common Resistant Bacteria and Wider Considerations for Practice.Infection and drug resistance · 2021Review
- [Evolution of hand hygiene adherence of health professionals of specialized care.]Revista espanola de salud publica · 2020Observational
- Reducing transmission of methicillin-resistantInfection prevention in practice · 2019Article
- Nation-wide survey of screening practices to detect carriers of multi-drug resistant organisms upon admission to Swiss healthcare institutions.Antimicrobial resistance and infection control · 2019Article
- Interventions to improve hand hygiene compliance in patient care: Reflections on three systematic reviews for the Cochrane Collaboration 2007-2017.Journal of infection prevention · 2018Review
- Methicillin-Resistant Staphylococcus aureus Control in the 21st Century: Laboratory Involvement Affecting Disease Impact and Economic Benefit from Large Population Studies.Journal of clinical microbiology · 2016Review
- Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship-Quasi-Experimental Designs.Infection control and hospital epidemiology · 2016Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 12 institutions in 11 countries.
Funding
Abstract
objectiveTo compare the effect of two strategies (enhanced hand hygiene vs meticillin-resistant Staphylococcus aureus (MRSA) screening and decolonisation) alone and in combination on MRSA rates in surgical wards.
designProspective, controlled, interventional cohort study, with 6-month baseline, 12-month intervention and 6-month washout phases.
setting33 surgical wards of 10 hospitals in nine countries in Europe and Israel.
participantsAll patients admitted to the enrolled wards for more than 24 h.
interventionsThe two strategies compared were (1) enhanced hand hygiene promotion and (2) universal MRSA screening with contact precautions and decolonisation (intranasal mupirocin and chlorhexidine bathing) of MRSA carriers. Four hospitals were assigned to each intervention and two hospitals combined both strategies, using targeted MRSA screening. OUTCOME MEASURES: Monthly rates of MRSA clinical cultures per 100 susceptible patients (primary outcome) and MRSA infections per 100 admissions (secondary outcome). Planned subgroup analysis for clean surgery wards was performed.
resultsAfter adjusting for clustering and potential confounders, neither strategy when used alone was associated with significant changes in MRSA rates. Combining both strategies was associated with a reduction in the rate of MRSA clinical cultures of 12% per month (adjusted incidence rate ratios (aIRR) 0.88, 95% CI 0.79 to 0.98). In clean surgery wards, strategy 2 (MRSA screening, contact precautions and decolonisation) was associated with decreasing rates of MRSA clinical cultures (15% monthly decrease, aIRR 0.85, 95% CI 0.74 to 0.97) and MRSA infections (17% monthly decrease, aIRR 0.83, 95% CI 0.69 to 0.99).
conclusionsIn surgical wards with relatively low MRSA prevalence, a combination of enhanced standard and MRSA-specific infection control approaches was required to reduce MRSA rates. Implementation of single interventions was not effective, except in clean surgery wards where MRSA screening coupled with contact precautions and decolonisation was associated with significant reductions in MRSA clinical culture and infection rates.
trial registrationclinicaltrials.gov identifier: NCT00685867.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.