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Pre-emptive isolation, ultrarapid PCR led to decrease in MRSA at hospital
The combination of pre-emptive isolation precautions and ultrarapid PCR screening led to a decrease in MRSA colonization and incidence of nosocomial MRSA cases at one of the largest emergency hospitals in Germany, according to researchers.
“The most important finding of our study was the continuous reduction in the nosocomial colonization rate after pre-emptive isolation precautions of all MRSA-risk patients in combination with ultrarapid PCR screening,” Ghias Hallak, MD, of the department of orthopedic and trauma surgery at Unfallkrankenhaus Berlin, and colleagues wrote in Infection Control and Hospital Epidemiology.
For the second phase of their study, which was conducted over 31 months beginning in March 2008, Hallak and colleagues screened high-risk patients for MRSA at hospital admission using PCR, which decreased the mean time it took to get a notification of MRSA infection from 62.8 hours using conventional microbiological screening to 1.98 hours using PCR.
MRSA bacteria, digitally colorized to appear green, being enveloped by a human white blood cell.
Source: NIAID
Also in the second phase, patients remained isolated from hospital admission onwards, whereas patients were only isolated in the first phase once MRSA was confirmed via test results.
Following implementation of the PCR screening, nosocomial MRSA cases decreased from seven per 10,000 patient-days to fewer than three per 10,000 patient-days, a decline that was driven mainly by a decrease in nosocomial MRSA colonization, Hallak and colleagues wrote.
“The study results are relevant for prevention of nosocomial infections in general,” Hallak and colleagues concluded. “Data suggest that the first 2 to 3 hospital days are critical for the spread of bacteria. Only the combination of ultrarapid PCR screening of all high-risk patients with pre-emptive isolation precautions, and rigorous hygiene management substantially reduced the MRSA transmission rate.” – by Gerard Gallagher
Disclosure: Hallak reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.