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Published on: June 7, 2017
Impact of screening and identifying methicillin-resistant Staphylococcus aureus carriers on hand hygiene compliance
Hikombo Hitoto1, Achille Kouatchet, Laurent Dubé
1Laboratory of Clinical Microbiology and Hygiene, Angers University Hospital, France.
Background:
Our objective was to assess the impact of screening and identifying methicillin-resistant Staphylococcus aureus (MRSA) carriers as a single measure in 4 intensive care units (ICUs).
Methods:
An evaluative study including two 6-month periods was conducted prospectively. The evaluation concerned the hand hygiene compliance (HHC) for contacts with MRSA carriers versus contacts with noncarriers (comparison C1, main objective) and for a period of absence of identification (P1) versus a period of identification (P2) (comparison C2) and MRSA cross transmission (P1 vs P2) (comparison C3) measured with 2 indicators.
Results:
Overall, 1326 opportunities of hand hygiene were observed. Concerning C1, the HHC for contacts with MRSA carriers was 42.5% versus 43.1% for contacts with noncarriers (not significant). This absence of difference was recorded whatever the ICU specialty, the category of personnel, and the nature of contacts. Concerning C2, the HHC in P1 was 44.8% versus 48.5% in P2 (not significant). Concerning C3, no significant difference was identified between the 2 periods.
Conclusion:
We did not identify any advantage by using screening and identifying MRSA carriers in those 4 ICUs in which no specific strategy of additional contact measures was implemented for MRSA carriers.
Insights
Screening for methicillin-resistant Staphylococcus aureus (MRSA) carriers in intensive care units (ICUs) did not improve hand hygiene compliance or reduce MRSA transmission when implemented as a standalone measure.
Area of Science:
- Infection Control
- Public Health
- Medical Microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings, particularly intensive care units (ICUs).
- Identifying MRSA carriers is a strategy to control its spread, but its effectiveness as a single measure requires evaluation.
Purpose of the Study:
- To assess the impact of screening and identifying MRSA carriers as a standalone intervention in four ICUs.
- To evaluate changes in hand hygiene compliance and MRSA cross-transmission.
Main Methods:
- A prospective, evaluative study was conducted over two 6-month periods.
- Hand hygiene compliance (HHC) was compared between contacts of MRSA carriers and non-carriers.
- HHC and MRSA cross-transmission were compared between periods with and without MRSA carrier identification.
Main Results:
- No significant difference in HHC was observed between contacts of MRSA carriers and non-carriers (42.5% vs. 43.1%).
- No significant difference in HHC was found between periods with and without MRSA carrier identification (44.8% vs. 48.5%).
- No significant difference in MRSA cross-transmission was identified between the two study periods.
Conclusions:
- Screening and identifying MRSA carriers as a single measure did not yield any demonstrable advantage in the studied ICUs.
- The findings suggest that additional contact precautions are necessary for MRSA carriers to impact transmission rates.
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