Effectiveness of hospital-wide methicillin-resistant Staphylococcus aureus (MRSA) infection control policies differs by ward specialty

PLoS One. 2013 Dec 10;8(12):e83099. doi: 10.1371/journal.pone.0083099. eCollection 2013.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of preventable nosocomial infections and is endemic in hospitals worldwide. The effectiveness of infection control policies varies significantly across hospital settings. The impact of the hospital context towards the rate of nosocomial MRSA infections and the success of infection control is understudied. We conducted a modelling study to evaluate several infection control policies in surgical, intensive care, and medical ward specialties, each with distinct ward conditions and policies, of a tertiary public hospital in Sydney, Australia. We reconfirm hand hygiene as the most successful policy and find it to be necessary for the success of other policies. Active screening for MRSA, patient isolation in single-bed rooms, and additional staffing were found to be less effective. Across these ward specialties, MRSA transmission risk varied by 13% and reductions in the prevalence and nosocomial incidence rate of MRSA due to infection control policies varied by up to 45%. Different levels of infection control were required to reduce and control nosocomial MRSA infections for each ward specialty. Infection control policies and policy targets should be specific for the ward and context of the hospital. The model we developed is generic and can be calibrated to represent different ward settings and pathogens transmitted between patients indirectly through health care workers. This can aid the timely and cost effective design of synergistic and context specific infection control policies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Australia
  • Computer Simulation
  • Cost-Benefit Analysis
  • Cross Infection / economics
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control*
  • Hospital Administration
  • Hospitals
  • Humans
  • Infection Control / methods*
  • Infection Control / standards
  • Methicillin-Resistant Staphylococcus aureus*
  • Models, Theoretical
  • Patient Isolation
  • Personnel Staffing and Scheduling
  • Retrospective Studies
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / prevention & control*
  • Staphylococcal Infections / transmission*

Grants and funding

Rosemarie Sadsad was supported by a PhD research scholarship from the HCF Health and Medical Research Foundation (http://www.hcf.com.au/about-us/hcf-foundation/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.