Nosocomial Acquisition of Methicillin-ResistantStaphylococcus aureusDuring an Outbreak of Severe Acute Respiratory Syndrome

2005 ◽  
Vol 26 (2) ◽  
pp. 134-137 ◽  
Author(s):  
Susan M. Poutanen ◽  
Mary Vearncombe ◽  
Allison J. McGeer ◽  
Michael Gardam ◽  
Grant Large ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Retrospective Cohort ◽  
Healthcare Workers ◽  
Community Hospital ◽  
Tertiary Care ◽  
Appropriate Use ◽  
Contact Precautions ◽  
Control Education ◽  
Tertiary Care Hospitals

AbstractObjective:The four hospitals assessed in this study use active surveillance cultures for methicillin-resistantStaphylococcus aureus(MRSA) and contact precautions for MRSA-positive patients as part of routine infection control practices. The objective of this study was to determine whether nosocomial acquisition of MRSA decreased in these hospitals during an outbreak of severe acute respiratory syndrome (SARS) when barrier precautions were routinely used for all patients.Design:Retrospective cohort study.Setting:Three tertiary-care hospitals (a 1,100-bed hospital; a 500-bed hospital; and an 823-bed hospital) and a 430-bed community hospital, each located in Toronto, Ontario, Canada.Patients:All admitted patients were included.Results:The nosocomial rate of MRSA in all four hospitals combined during the SARS outbreak (3.7 per 10,000 patient-days) was not significantly different from that before (4.7 per 10,000 patient-days) or after (3.4 per 10,000 patient-days) the outbreak (P= .30 andP= .76, respectively). The nosocomial rate of MRSA after the outbreak was significantly lower than that before the outbreak (P= .003). Inappropriate reuse of gloves and gowns and failure to wash hands between patients on non-SARS wards were observed during the outbreak. Increased attention was paid to infection control education following the outbreak.Conclusions:Inappropriate reuse of gloves and gowns and failure to wash hands between patients may have contributed to transmission of MRSA during the SARS outbreak. Attention should be paid to training healthcare workers regarding the appropriate use of precautions as a means to protect themselves and patients.

Strict Infection Control Leads to Low Incidence of Methicillin-ResistantStaphylococcus aureusBloodstream Infection over 20 Years

2015 ◽  
Vol 36 (6) ◽  
pp. 702-709 ◽  
Author(s):  
Andreas F. Widmer ◽  
Botond Lakatos ◽  
Reno Frei
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
University Hospital ◽  
Multiple Infection ◽  
Case Report Form ◽  
Contact Precautions

OBJECTIVEMethicillin-resistantStaphylococcus aureus(MRSA) is a worldwide issue associated with significant morbidity and mortality. Multiple infection control (IC) approaches have been tested to control its spread; however, the success of the majority of trials has been short-lived and many efforts have failed. We report the long-term success of MRSA control from a prospective observational study over 20 years.SETTINGUniversity Hospital Basel is a large tertiary care center with a median bed capacity of 855 and 5 intensive care units (ICUs); currently, the facility has >32,000 admissions per year.METHODSThe IC program at the University Hospital Basel was created in 1993, after 2 MRSA outbreaks. The program has included strict contact precautions with single rooms for MRSA-colonized or -infected patients, targeted admission screening of high-risk patients and healthcare workers at risk for carriage, molecular typing of all MRSA strains and routine decolonization of MRSA carriers including healthcare workers. We used the incidence of MRSA bloodstream infections (BSIs) to assess the effectiveness of this program. All MRSA cases were prospectively classified using a standardized case report form in nosocomial and nonnosocomial cases, based on CDC definitions.RESULTSBetween 1993 and 2012, 540,669 blood samples were cultured. The number of blood cultures increased from 865 per 10,000 patient days in 1993 to 1,568 per 10,000 patient days in 2012 (P<.001). We identified 1,268 episodes ofS. aureusBSI from 1,204 patients. MRSA accounted for 34 episodes (2.7%) and 24 of these (1.9%) were nosocomial. MRSA BSI incidence varied between 0 and 0.27 per 10,000 patient days and remained stable with no significant variation throughout the study period (P=.882).CONCLUSIONSLong-term control of MRSA is feasible when a bundle of IC precautions is strictly enforced over time.Infect Control Hosp Epidemiol2015;00(0): 1–8

Compliance With Routine Use of Gowns by Healthcare Workers (HCWs) and Non-HCW Visitors on Entry Into the Rooms of Patients Under Contact Precautions

2007 ◽  
Vol 28 (3) ◽  
pp. 337-340 ◽  
Author(s):  
Farrin A. Manian ◽  
John J. Ponzillo
Keyword(s):  
Healthcare Workers ◽  
Prospective Observational Study ◽  
Community Hospital ◽  
Medical Center ◽  
Tertiary Care ◽  
Contact Precautions ◽  
Teaching Community ◽  
Direct Exposure ◽  
General Wards ◽  
The Relationship

Background.Modified contact precautions (MCP), defined as routine donning of isolation gowns (along with routine gloving) on entry into the rooms of patients under contact precautions, regardless of the likelihood of direct exposure to the patient or their immediate environment, were instituted at our medical center to reduce nosocomial transmission of common hospital pathogens.Objectives.To study compliance with MCP policy regarding routine gowning in intensive care units (ICUs) and general wards and to determine the relationship between gown and glove use in the care of patients under MCP in ICUs.Design.Prospective observational study from February 20, 2004, through January 8, 2005, involving 2,110 persons (1,504 healthcare workers [HCWs] and 606 non-HCW visitors).Setting.A 900-bed tertiary care teaching community hospital.Results.Overall compliance with routine gown use was observed for 1,542 persons (73%), including 1,150 HCWs (76%) and 392 visitors (65%) (odds ratio [OR], 1.8 [95% confidence interval {CI}, 1.4-2.2]; P < .001). Visitors in the ICUs (186 [91%] of 204) were more likely than visitors in the general wards (202 [51%] of 398) to comply with gown use (OR, 10 [95% CI, 6.0-17.0]; P < .001). In logistic regression analysis, independent predictors of gown compliance among HCWs were female sex (OR, 2.3 [95% CI, 1.8-3.0]; P < .001) and ICU setting (OR, 2.2 [95% CI, 1.7-2.9]; P < .001). In the ICUs, gown use was highly predictive of glove use among HCWs (positive predictive value, 95%).Conclusion.Improvement in compliance with gown use at our medical center will require more-intensive educational efforts targeted at male HCWs and at HCWs and visitors on general wards. In the care of ICU patients under MCP, HCW compliance with gown use may be used as a proxy for their compliance with glove use.

Infection control and antimicrobial restriction practices for antimicrobial-resistant organisms in Canadian tertiary care hospitals

2007 ◽  
Vol 35 (9) ◽  
pp. 563-568 ◽  
Author(s):  
Marianna Ofner-Agostini ◽  
◽  
Monali Varia ◽  
Lynn Johnston ◽  
Karen Green ◽  
...  
Keyword(s):  
Infection Control ◽  
Tertiary Care ◽  
Tertiary Care Hospitals

Effect of a Multifaceted Intervention on Adherence to Hand Hygiene among Healthcare Workers: A Cluster-Randomized Trial

2010 ◽  
Vol 31 (11) ◽  
pp. 1170-1176 ◽  
Author(s):  
Dominik Mertz ◽  
Nancy Dafoe ◽  
Stephen D. Walter ◽  
Kevin Brazil ◽  
Mark Loeb
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Intervention Group ◽  
Multifaceted Intervention ◽  
Cluster Randomized ◽  
Hospital Acquired ◽  
Tertiary Care Hospitals ◽  
The Impact ◽  
Mrsa Colonization

Objectives.Adherence to hand hygiene among healthcare workers (HCWs) is widely believed to be a key factor in reducing the spread of healthcare-associated infection. The objective of this study was to evaluate the impact of a multifaceted intervention to increase rates of adherence to hand hygiene among HCWs and to assess the effect on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) colonization.Design.Cluster-randomized controlled trial.Setting.Thirty hospital units in 3 tertiary care hospitals in Hamilton, Ontario, Canada.Intervention.After a 3-month baseline period of data collection, 15 units were randomly assigned to the intervention arm (with performance feedback, small-group teaching seminars, and posters) and 15 units to usual practice. Hand hygiene was observed during randomly selected 15-minute periods on each unit, and the incidence of MRSA colonization was measured using weekly surveillance specimens from June 2007 through May 2008.Results.We found that 3,812 (48.2%) of 7,901 opportunities for hand hygiene in the intervention group resulted in adherence, compared with 3,205 (42.6%) of 7,526 opportunities in the control group (P < .001; independent t test). There was no reduction in the incidence of hospital-acquired MRSA colonization in the intervention group.Conclusion.Among HCWs in Ontario tertiary care hospitals, the rate of adherence to hand hygiene had a statistically significant increase of 6% with a multifaceted intervention, but the incidence of MRSA colonization was not reduced.

A Prolonged Outbreak of Methicillin-Resistant Staphylococcus aureus in the Burn Unit of a Tertiary Medical Center

1996 ◽  
Vol 17 (12) ◽  
pp. 798-802 ◽  
Author(s):  
Patricia A. Meier ◽  
Cheryl D. Carter ◽  
Sarah E. Wallace ◽  
Richard J. Hollis ◽  
Michael A. Pfaller ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Healthcare Workers ◽  
Medical Center ◽  
Tertiary Care ◽  
Chromosomal Dna ◽  
Methicillin Resistant ◽  
Persistent Problem ◽  
Tertiary Care Medical Center ◽  
Burn Unit

AbstractObjective:To report an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in our burn unit and the steps we used to eradicate the organism.Design And Setting:Outbreak investigation in the burn unit of a 900-bed tertiary-care medical center.Outbreak:Between March and June 1993, MRSA was isolated from 10 patients in our burn unit. All isolates had identical antibiograms and chromosomal DNA patterns.Control Measures:Infection control personnel encouraged healthcare workers to wash their hands after each patient contact. The unit cohorted all infected or colonized patients, placed each affected patient in isolation, and, if possible, transferred the patient to another unit. Despite these measures, new cases occurred. Infection control personnel obtained nares cultures from 56 healthcare workers, 3 of whom carried the epidemic MRSA strain. One healthcare worker cared for six affected patients, and one cared for five patients. We treated the three healthcare workers with mupirocin. Subsequently, no additional patients became colonized or infected with the epidemic MRSA strain.Conclusions:The outbreak ended after we treated healthcare workers who carried the epidemic strain with mupirocin. This approach is not appropriate in all settings. However, we felt it was justified in this case because of a persistent problem after less intrusive measures.

Factors Associated With Critical-Care Healthcare Workers' Adherence to Recommended Barrier Precautions During the Toronto Severe Acute Respiratory Syndrome Outbreak

2007 ◽  
Vol 28 (11) ◽  
pp. 1275-1283 ◽  
Author(s):  
A. Shigayeva ◽  
K. Green ◽  
J. M. Raboud ◽  
B. Henry ◽  
A. E. Simor ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Healthcare Workers ◽  
Apache Ii ◽  
Recent Infection ◽  
Factors Associated ◽  
Interactive Training ◽  
Two Factors ◽  
Score Apache ◽  
Self Protection

Objective.To assess factors associated with adherence to recommended barrier precautions among healthcare workers (HCWs) providing care to critically ill patients with severe acute respiratory syndrome (SARS).Setting.Fifteen acute care hospitals in Ontario, CanadaDesign.Retrospective cohort study.Patients.All patients with SARS who required intubation during the Toronto SARS outbreak in 2003.Participants.HCWS who provided care to or entered the room of a SARS patient during the period from 24 hours before intubation until 4 hours after intubation.Methods.Standardized interviews were conducted with eligible HCWs to assess their interactions with the SARS patient, their use of barrier precautions, their practices for removing personal protective equipment, and the infection control training they received.Results.Of 879 eligible HCWs, 795 (90%) participated. In multivariate analysis, the following predictors of consistent adherence to recommended barrier precautions were identified: recognition of the patient as a SARS case (odds ratio [OR], 2.5 [95% confidence interval {CI}, 1.5-4.5); recent infection control training (OR for interactive training, 2.7 [95% CI, 1.7-4.4]; OR for passive training, 1.7 [95% CI, 1.0-3.0]), and working in a SARS unit (OR, 4.0 [95% CI, 1.8-8.9]) or intensive care unit (OR, 4.3 [95% CI, 2.0-9.0]). Two factors were associated with significantly lower rates of consistent adherence: the provision of care for patients with higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores (OR for score APACHE II of 20 or greater, 0.4 [95% CI, 0.28-0.68]) and work on shifts that required more frequent room entry (OR for 6 or more entries per shift, 0.5 [95% CI, 0.32-0.86]).Conclusions.There were significant deficits in knowledge about self-protection that were partially corrected by education programs during the SARS outbreak. HCWs' adherence to self-protection guidelines was most closely associated with whether they provided care to patients who had received a definite diagnosis of SARS.

scholarly journals Family caregivers in public tertiary care hospitals in Bangladesh: Risks and opportunities for infection control

2014 ◽  
Vol 42 (3) ◽  
pp. 305-310 ◽  
Author(s):  
M. Saiful Islam ◽  
Stephen P. Luby ◽  
Rebeca Sultana ◽  
Nadia Ali Rimi ◽  
Rashid Uz Zaman ◽  
...  
Keyword(s):  
Infection Control ◽  
Family Caregivers ◽  
Tertiary Care ◽  
Tertiary Care Hospitals

scholarly journals Impact of Infection Prevention and Control Education Program on Improving Knowledge, Attitude and Practices of the Healthcare Staff in Hemodialysis Unit at Egyptian Tertiary Care Facility

2019 ◽  
pp. 1-11
Author(s):  
Marwa Ahmed Abdelwahab ◽  
Eman Abdel Raheem Labah ◽  
Laila Mahmoud Sayed ◽  
Mohamed Mokhtar Elbedwey ◽  
Heba Mohamed Gabr
Keyword(s):  
Infection Control ◽  
Education Program ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Phase Iii ◽  
Infection Prevention And Control ◽  
Hemodialysis Unit ◽  
Control Education ◽  
And Control

Objective: Infection is a leading cause of hospitalization and the second most common cause of mortality among hemodialysis (HD) patients. The aim of this study is to assess the impact of infection prevention and control education program on improving healthcare workers knowledge, attitude and practices and reducing incidence of infection in the hemodialysis unit. Methodology: All patients and healthcare workers in the unit within the study period were included. This study was conducted through 3 phases; Phase I: base line survey for assessment of infection prevention and control knowledge, attitude and practices among healthcare workers, Phase II: Intervention that included infection control standardized education program followed by post education survey. Phase III: Implementation of infection control program was done associated with assessment of blood born viruses (HCV, HBV & HIV) and monitoring patients for fever and/or local signs of inflammation at catheter exit or at skin around shunt to be subjected to blood culture. Results: Health care workers knowledge, attitude and practices of infection prevention and control before intervention were unsatisfactory followed by significant improvement reflecting the effectiveness of such interventions. Regarding incidence of infection there were three cases of blood stream infections; two of them were multidrug resistant organisms (MDROs) and no reported cases of seroconverion for HIV, HCV or HBV during study period.  Conclusion: Lack of knowledge about infection prevention and control practices in hemodialysis unit could be significantly improved by standardized education program which results in reducing incidence of infections in such units.

scholarly journals Compliance to infection prevention and control practices for prevention of SARS-CoV-2 transmission at tertiary care hospital in North Mumbai

2021 ◽  
Vol 8 (10) ◽  
pp. 4837
Author(s):  
Kinjal Patel ◽  
Suraj Purusottaman ◽  
Trupti Carval ◽  
Lekhan Narvekar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Infection Prevention And Control ◽  
Care Hospital ◽  
And Control

Background: Infection control practices played a major role in prevention of SARS-CoV-2 in healthcare settings. Aim of the study was to know the compliance to infection control and prevention practices by healthcare workers in COVID-19 pandemic and the measures taken for prevention of SARS-CoV-2 spread in the hospital.Methods: An observational study was conducted at tertiary care hospital for a period of one month. All healthcare workers involved in patient care of COVID-19 and non COVID-19 was observed for their infection control practices. Areas were divided in two category, intensive care unit and indoor wards for audit. Environmental samples of various surfaces from intensive care unit and wards were taken and analyzed for the presence of SARS-CoV-2 RNA by reverse transcriptase polymerase chain reaction.Results: Overall compliance to infection prevention practices were improved during pandemic. Hand hygiene compliance in intensive care unit and indoor wards of COVID-19 unit were 78.66% and 74.36% whilst in non COVID-19 units was 72.47% and 62.31% respectively. Compliance to revised biomedical waste (BMW) policy at COVID-19 unit were 85.20% and 71.49% in intensive care unit and ward respectively. However, at non COVID-19 unit, it was 65.22% and 57.60%. Nursing station and doffing area of ICU at non-COVID-19 unit showed presence of SARS-CoV-2 virus. While all samples collected from COVID-19 unit were negative.Conclusions: Infection prevention and control practices play a key role to curtail transmission of infection. Awareness among healthcare workers, hospital environment, and usage of personal protective equipment should be optimized even at non COVID-19 facility.

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