French approach featured surveillance, barriers, hand hygiene; burden fell by 35 percent
THURSDAY, March 25 (HealthDay News) -- Over the long term, the use of an intensive program can reduce the burden of methicillin-resistant Staphylococcus aureus (MRSA) in a large hospital institution, according to research published in the March 22 issue of the Archives of Internal Medicine.
Vincent Jarlier, M.D., of the Groupe Hospitalier Pitié-Salpêtrière in Paris, and colleagues analyzed data on trends related to MRSA burden and control in the Assistance Publique-Hôpitaux de Paris, a multi-hospital public medical institution. The program, launched in 1993, included surveillance, barrier precautions, and, starting in 2001, hand hygiene promotion.
The authors note that MRSA burden decreased by 35 percent between 1993 and 2007. The proportion of MRSA among S. aureus strains fell from 41 to 26.6 percent overall and from 45.3 to 24.2 percent in blood cultures. Incidence of MRSA cases fell from 0.86 to 0.56 per 1,000 hospital days. The decrease in burden was steeper in intensive-care units than surgical wards and medical wards (relative changes, −59, −44, and −32 percent, respectively). The use of alcohol-based hand rubs increased from 2 to 21 liters per 1,000 hospital days.
"Effective control of MRSA in epidemic settings has been extensively demonstrated, but the feasibility of controlling endemic situations with high MRSA rates has been questioned. Our study demonstrates that this objective can be reached at the scale of a large medical institution," Jarlier and colleagues conclude.
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