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Updated: Feb 23, 2026
Development and Assessment of Intracellular Infection Models for Staphylococcus aureus
Published on: January 17, 2025
Impact of a mandatory infection control education program on nosocomial acquisition of methicillin-resistant
Todd C Lee1, Christine Moore, Janet M Raboud
1University of Toronto, Canada.
Objective:
To assess the impact of an institution-wide infection control education program on the rate of transmission of methicillin-resistant Staphylococcus aureus (MRSA).
Design:
Before-and-after study.
Setting:
A 472-bed, urban, university-affiliated hospital.Intervention. During the period March-May 2004, all hospital staff completed a mandatory infection control education program, including the receipt of hospital-specific MRSA data and case-based practice with additional precautions.
Outcome Measure:
The rate of nosocomial MRSA acquisition was calculated as the number of cases of nosocomial MRSA acquisition per 100 days that a person with MRSA colonization or infection detected at admission is present in the hospital ("admission MRSA" exposure-days) for 3 time periods: June 2002-February 2003 (before the Toronto outbreak of severe acute respiratory syndrome [SARS]), June 2003-February 2004 (after the outbreak of SARS), and June 2004-February 2005 (after education). A case of nosocomial acquisition of MRSA colonization or infection represented a patient first identified as colonized or infected more than 72 hours after admission or at admission after a previous hospitalization.
Results:
The rate of nosocomial acquisition of MRSA colonization or infection was 8.8 cases per 100 admission MRSA exposure-days for the period before SARS, 3.8 cases per 100 admission MRSA exposure-days for the period after SARS (P<.001 for before SARS vs after SARS), and 1.9 cases per 100 admission MRSA exposure-days for the period after education (P=.02 for after education vs before education). The volume of alcohol-based handrub purchased was apparently stable, with 4,010 L during fiscal year 2003-2004 (April 2003-March 2004) compared with 3,780 L during fiscal year 2004-2005. The observed rate of compliance with hand washing did not change significantly (40.9% during education vs 44.2% after education; P=.23). The total number of patients screened for MRSA colonization was not different in the 3 periods.
Conclusions:
The rate of nosocomial acquisition of MRSA colonization or infection decreased after SARS and was further reduced in association with a hospital-wide education program.
Insights
A hospital-wide infection control education program significantly reduced methicillin-resistant Staphylococcus aureus (MRSA) transmission rates. This initiative, following the SARS outbreak, further decreased MRSA acquisition, demonstrating the program's effectiveness in enhancing patient safety.
Area of Science:
- Infection Control
- Hospital Epidemiology
- Public Health
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
- Understanding transmission dynamics is crucial for effective control strategies.
- Previous outbreaks, like SARS, have highlighted the need for robust infection control measures.
Purpose of the Study:
- To evaluate the impact of a comprehensive infection control education program on MRSA transmission.
- To quantify changes in nosocomial MRSA acquisition rates following the educational intervention.
- To assess the program's effectiveness in a large urban university-affiliated hospital.
Main Methods:
- A before-and-after study design was employed.
- The study involved a 472-bed hospital, with all staff participating in a mandatory education program.
- Nosocomial MRSA acquisition rates were calculated per 100 admission MRSA exposure-days over three distinct periods.
Main Results:
- MRSA acquisition rates decreased from 8.8 cases per 100 exposure-days before SARS to 3.8 after SARS (P<.001).
- Following the education program, rates further reduced to 1.9 cases per 100 exposure-days (P=.02).
- Hand hygiene compliance and alcohol-based hand rub purchases remained stable, indicating education was the primary driver of reduction.
Conclusions:
- A hospital-wide infection control education program was associated with a significant reduction in MRSA acquisition.
- The educational intervention demonstrated further effectiveness in lowering MRSA transmission rates.
- These findings underscore the importance of targeted education in combating healthcare-associated infections.
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