Trend of MRSA bacteremia in an institution with a high rate of MRSA after the reinforcement of antibiotic stewardship and hand hygiene

Abstract

Background : Some studies show that efforts to reduce health care-associated infections with methicillin-resistant Staphylococcus aureus (MRSA) are effective.Method : Two infection control programs were reinforced in the hospital in South Korea where the MRSA rate is about 65%. “Antibiotic stewardship” was intensified starting in August 2008, when a computerized prescription restriction was implemented. “Hand hygiene”, consistent with World Health Organization (WHO) guidelines, started in December 2008. The incidence of MRSA BSI was evaluated using laboratory database. Result : From January 2006 through November 2011, there were 568 episodes of MRSA BSI. Incidence of MRSA BSI was reduced in a year after these programs were implemented from 0.171 per 1,000 patient-days in 2009 to 0.116 per 1,000 patient-days in 2011 (P = .009). There was a decrease in antibiotic consumption from 690.54 ± 28.33 as the monthly mean defined daily dose (DDD) per 1,000 patients-days in 2008 to 652.47 ± 20.77 2011 (P = .015). The rates of performance in hand hygiene have been increased from 43% in 2008 to 83% in 2011 (P = .043). Conclusion : Although we did not implement all components of the “MRSA bundle”, there was a decrease in MRSA BSI after the reinforcement of antibiotic stewardship and hand hygiene over a three year period in this institute which previously had a high rate of MRSA.