Control of an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) by hygienic measures in a general intensive care unit

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Microbiology

Background:

• Infections pose a significant mortality risk for critically ill patients.
• Gram-positive organisms, including methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE), are prevalent in Intensive Care Units (ICUs).
• Overcrowding in ICUs facilitates the rapid spread of resistant bacteria.

Purpose of the Study:

• To investigate the efficacy of enhanced hygienic procedures and educational programs in controlling the spread of resistant bacteria in an ICU.
• To test the hypothesis that strict regulations and staff education can mitigate the dissemination of antibiotic-resistant organisms.

Main Methods:

• Implementation of reinforced hygienic protocols and patient segregation in a 16-bed medico-surgical ICU.
• Introduction of educational programs for medical and nursing personnel.
• Surveillance cultures of bronchial secretions were analyzed before and after the intervention.

Main Results:

• A significant reduction in MRSA isolation rates from 60.0% to 37.7% between 1991 and 1992.
• A marked decrease in MRSE isolation rates from 36.4% to 6.2% during the same period.
• Associated reductions in lower respiratory tract infections and overall crude mortality were observed.

Conclusions:

• Prompt implementation of stringent infection control measures, including enhanced hygiene and patient isolation, is effective in managing outbreaks of resistant staphylococci.
• Continuous education and reinforcement of protocols for medical and nursing staff are crucial for sustained control of resistant bacteria in ICUs.