Topical antimicrobials in combination with admission screening and barrier precautions to control endemic methicillin-resistant Staphylococcus aureus in an Intensive Care Unit.

摘要: We aimed to establish whether screening for methicillin-resistant Staphylococcus aureus (MRSA) and body decontamination upon admission an Intensive Care Unit (ICU), in combination with barrier precautions, reduced rates of MRSA infection acquired on the unit. This was interrupted time series study employing segmented regression analysis data collected all patients admitted a 16-bed adult ICU over 48 months. Before intervention (24 months; 1232 (44% female)), sought from clinical cultures only positive were nursed isolation. During 1421 (54% screened single rooms when established as MRSA-positive; given topical nasal anti-MRSA preparations daily bed baths 4% chlorhexidine throughout their stay. Changes proportion colonised or infected assessed. intervention, 193 new cases (16%) identified admissions; during this 92 (6%) admissions. By analysis, decreased by 11.38% ca. 15% 5% (ca. three-fold reduction) (95% confidence interval 3.5–19.3%; P = 0.005). Thus, treatment 11 prevented 1 case MRSA. Mean length stay significantly (P < 0.001). Although methicillin-susceptible S. bacteraemia dropped, changes detected not statistically significant. The coagulase-negative staphylococcal 0.001) trend changed increasing decreasing 0.001), did glycopeptide use 0.014). An inexpensive easy implement control highly successful without compromising antimicrobial susceptibility.