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Updated: Feb 21, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Infection control intervention on meticillin resistant Staphylococcus aureus transmission in residential care homes
Vivien Wm Chuang1, Iris Hl Tsang1, Jessica Py Keung1
1Infectious Disease Control Training Centre, Hospital Authority/ Infection Control Branch, Centre for Health Protection, Kowloon, China.
Background:
The objectives were to evaluate the effectiveness of an infection control bundle in controlling the meticillin resistant Staphylococcus aureus (MRSA) transmission in residential care homes for the elderly (RCHEs) in Hong Kong.
Methods:
This was a two-arm cluster randomised controlled trial. Infection control bundles focused on hand hygiene (HH), environmental hygiene, and modified contact precautions were applied to the intervention arm. Nasal swabs from residents; staff HH compliance and effectiveness; and environmental hygiene were assessed by microbiological sampling or observation at the baseline and quarterly after the intervention.
Results:
A total of 2776 residents from 36 RCHEs were recruited. The overall MRSA prevalence was 20.4% (95% confidence interval, 18.9%-21.9%). The intervention elicited an immediate effect of 2.4% absolute decrease in the prevalence and 3.7% in the intra-facility transmission, though the difference between the two arms was insignificant. Staff HH compliance increased substantially from 5.9% to 45.6% post-intervention (p < 0.001).
Conclusions:
We initiated the infection control culture into the RCHEs and gained their acceptance. However, this behavioural change takes time to emerge. Our study shows that relying on the bundle alone could not bring sustainable MRSA reduction. Administrative control for strengthening infection control infrastructure is important for continuous compliance and improvement.
Insights
An infection control bundle improved hand hygiene compliance in Hong Kong care homes but did not significantly reduce meticillin-resistant Staphylococcus aureus (MRSA) transmission alone. Sustainable MRSA reduction requires administrative support for infection control infrastructure.
Area of Science:
- Infectious Diseases
- Public Health
- Geriatric Care
Background:
- Meticillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in residential care homes for the elderly (RCHEs).
- Controlling MRSA transmission in RCHEs is crucial for resident safety and well-being.
Purpose of the Study:
- To evaluate the effectiveness of an infection control bundle in reducing MRSA transmission in Hong Kong RCHEs.
- To assess the impact of the bundle on hand hygiene, environmental hygiene, and MRSA prevalence.
Main Methods:
- A two-arm cluster randomised controlled trial involving 36 RCHEs and 2776 residents.
- Intervention included hand hygiene, environmental hygiene, and modified contact precautions.
- Microbiological sampling and observational assessments were conducted at baseline and quarterly.
Main Results:
- Overall MRSA prevalence was 20.4%.
- The intervention showed an immediate 2.4% decrease in prevalence and 3.7% in transmission, but differences between arms were not significant.
- Staff hand hygiene compliance increased significantly from 5.9% to 45.6%.
Conclusions:
- While the infection control bundle improved hand hygiene compliance, it did not achieve sustainable MRSA reduction on its own.
- Behavioral changes in infection control take time to manifest fully.
- Administrative support and robust infection control infrastructure are essential for continuous improvement and sustained MRSA reduction.
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