Journal of the Formosan Medical Association
Volume 109, Issue 4 , Pages 258-268, April 2010

Impact of Active Surveillance and Contact Isolation on Transmission of Methicillin-resistant Staphylococcus aureus in Intensive Care Units in an Area With High Prevalence

  • Jann-Tay Wang

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Tsai-Ling Lauderdale

      Affiliations

    • Division of Clinical Research, National Health Research Institute, Zhunan, Taiwan
    • ,
  • Wen-Sen Lee

      Affiliations

    • Department of Internal Medicine, Wan Fang Hospital, Taipei, Taiwan
    • ,
  • Jeng-Hua Huang

      Affiliations

    • Department of Internal Medicine, Taipei Cathay General Hospital, Taipei, Taiwan
    • ,
  • Tsung-Hsi Wang

      Affiliations

    • Center for Disease Control, Taipei, Taiwan
    • ,
  • Shan-Chwen Chang

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Shan-Chwen Chang, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 31 May 2009; received in revised form 4 June 2009; accepted 8 July 2009.

Article Outline

Background/Purpose

Previous research has suggested that active surveillance and early initiation of contact isolation (ASI) can control the nosocomial spread of methicillin-resistant Staphylococcus aureus (MRSA), especially among intensive care unit (ICU) patients. However, these interventions have never been implemented in Taiwan.

Methods

This study was conducted from September 2005 to October 2006 to evaluate the effect of ASI on the spread of MRSA in two medical centers in Taiwan with a high prevalence of MRSA. One ICU from each hospital was selected as a study site. In phase I (the first 6 months), only active surveillance was introduced. In phase II (the final 6 months), ASI for patients who had positive MRSA cultures was implemented.

Results

The incidence of acquiring MRSA during ICU stay did not differ significantly during phases I and II in hospital A (p = 0.940) and hospital B (p = 0.810). The independent risk factors for acquiring MRSA in the ICU were length of stay and presence of respiratory tract diseases.

Conclusion

This study demonstrated that, given the current resource limitations, ASI alone could not reduce MRSA transmission in two ICUs in Taiwan, where the MRSA prevalence was high.

Key Words:  intensive care units , methicillin-resistant Staphylococcus aureus , patient isolation , surveillance

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PII: S0929-6646(10)60051-4

doi:10.1016/S0929-6646(10)60051-4

Journal of the Formosan Medical Association
Volume 109, Issue 4 , Pages 258-268, April 2010

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