Isolation measures in the hospital management of methicillin resistant
            <i>Staphylococcus aureus</i>
            (MRSA): systematic review of the literature

Cooper, Ben; Stone, Sheldon; Kibbler, C C; Cookson, B.; Roberts, Jane; Medley, Graham; Duckworth, G.; Lai, Rosalind; Ebrahim, Shah

doi:10.1136/bmj.329.7465.533

Cited by 321 publications

(223 citation statements)

References 62 publications

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“…However, adherence to current guidelines, with isolation measures to reduce MRSA transmission, is supported by a recent systematic review. 17 Even as outpatients, attending the clinic or day unit, problems are encountered with patients requiring special 'areas' in which to be assessed, again not practical in many settings. Guidelines from the CDC 8 suggest that in centres where MRSA is problematic, patients should be treated as a cohort; however, a recent paper in The Lancet suggested that in the Intensive Therapy Unit setting, moving patients into single rooms or cohorted bays was not associated with a reduction in crossinfection.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak

Shaw

Boswell

Byrne

et al. 2007

Bone Marrow Transplant

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Section: Discussionmentioning

confidence: 99%

Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak

Shaw

Boswell

Byrne

et al. 2007

Bone Marrow Transplant

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“…Early contact isolation of patients colonized or infected with MRSA/VRE can limit their spread [2,3]. Consequently, most institutions try to identify and contact isolate these patients as early as possible during the admission process.…”

Section: A Introductionmentioning

confidence: 99%

An effective computerized reminder for contact isolation of patients colonized or infected with resistant organisms

Kho¹,

Dexter²,

Warvel³

et al. 2008

International Journal of Medical Informatics

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Purpose-To improve contact isolation rates among patients admitted to the hospital with a known history of infection with Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycinresistant Enterococci (VRE).Methods-A before and after interventional study implementing computerized reminders for contact isolation between February 25th of 2005 and February 28th of 2006. We measured rates of appropriate contact isolation, and time to isolation for the four month pre-intervention period, and the 12 month intervention period. We conducted a survey of ordering physicians at the midpoint of the intervention period.Results-Implementing a computerized reminder increased the rate of patients appropriately isolated from 33% to fully 89% (P < 0.0001). The median time to writing contact isolation orders decreased from 16.6 hours to 0.0 hours (P < 0.0001). Physicians accepted the order 80% of the time on the first or second presentation. 95% of physicians felt the reminder had no impact on workflow, or saved them time.Conclusion-A human reviewed computerized reminder can achieve high rates of compliance with infection control recommendations for contact isolation, and dramatically reduce the time to orders being written upon admission.

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“…However, studies on control measures are limited [3] and evidence for their effectiveness sparse and often contradictory [4]. Current guidelines are based on medical and scientific rationale and suggestive evidence rather than study results [4].…”

Section: Introductionmentioning

confidence: 99%

Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

2006

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SUMMARYWith reports of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) continuing to increase and therapeutic options decrease, infection control methods are of increasing importance. Here we investigate the relationship between surveillance and infection control. Surveillance plays two roles with respect to control : it allows detection of infected/colonized individuals necessary for their removal from the general population, and it allows quantification of control success. We develop a stochastic model of MRSA transmission dynamics exploring the effects of two screening strategies in an epidemic setting : random and on admission. We consider both hospital and community populations and include control and surveillance in a single framework. Random screening was more efficient at hospital surveillance and allowed nosocomial control, which also prevented epidemic behaviour in the community. Therefore, random screening was the more effective control strategy for both the hospital and community populations in this setting. Surveillance strategies have significant impact on both ascertainment of infection prevalence and its control.

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Isolation measures in the hospital management of methicillin resistant Staphylococcus aureus (MRSA): systematic review of the literature

Abstract: Objective To evaluate the evidence for the effectiveness of isolation measures in reducing the incidence of methicillin resistant Staphylococcus aureus (MRSA) colonisation and infection in hospital inpatients.

Cited by 321 publications

References 62 publications

Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak

Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak

An effective computerized reminder for contact isolation of patients colonized or infected with resistant organisms

Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

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