Impact of Active Surveillance and Contact Isolation on Transmission of Methicillin-resistant Staphylococcus aureus in Intensive Care Units in an Area With High Prevalence

• Main Authors: Jann-Tay Wang, Tsai-Ling Lauderdale, Wen-Sen Lee, Jeng-Hua Huang, Tsung-Hsi Wang, Shan-Chwen Chang
• Format: Article
• Language: English
• Published: Elsevier 2010-04-01
• Series: Journal of the Formosan Medical Association
• Subjects: intensive care units; methicillin-resistant Staphylococcus aureus; patient isolation; surveillance
• Online Access: http://www.sciencedirect.com/science/article/pii/S0929664610600514

Previous research has suggested that active surveillance and early initiation of contact isolation (ASI) can control the nosocomial spread of methicillin-resistant Staphylococcus aureus (MRSA), especially among intensive care unit (ICU) patients. However, these interventions have never been implemented in Taiwan. Methods: This study was conducted from September 2005 to October 2006 to evaluate the effect of ASI on the spread of MRSA in two medical centers in Taiwan with a high prevalence of MRSA. One ICU from each hospital was selected as a study site. In phase I (the first 6 months), only active surveillance was introduced. In phase II (the final 6 months), ASI for patients who had positive MRSA cultures was implemented. Results: The incidence of acquiring MRSA during ICU stay did not differ significantly during phases I and II in hospital A (p = 0.940) and hospital B (p = 0.810). The independent risk factors for acquiring MRSA in the ICU were length of stay and presence of respiratory tract diseases. Conclusion: This study demonstrated that, given the current resource limitations, ASI alone could not reduce MRSA transmission in two ICUs in Taiwan, where the MRSA prevalence was high.