Hospital-Onset Bloodstream Infection Rates after Discontinuing Active Surveillance Cultures for Methicillin-Resistant Staphylococcus aureus in a Regional Burn Center

Date

2018-02-21

Authors

Drum, Bayless

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Abstract

Infections caused by antibiotic resistant bacteria including methicillin-resistant Staphylococcus aureus (MRSA) are associated with increased morbidity and mortality in hospitalized patients. Active surveillance culture (ASC) programs that involve identifying asymptomatically colonized patients and placing them on contact precautions have been promoted to control the spread of hospital-onset (HO) infections. Burn patients are particularly susceptible to staphylococcal infection, but a complete understanding of the effectiveness of ASC programs in preventing HO infections among burn patients is limited. The objective of this retrospective observational study is to describe the epidemiology of MRSA among patients in an academic medical center burn unit including the impact of removal of an ASC program on HO MRSA blood stream infections (BSI) in order to inform control efforts in this population. This study was done in the Burn Intensive Care Unit and Burn Acute Care Unit of Parkland Memorial Hospital. The study period was December 2011 to February 2016. The ASC program was discontinued in August 2014. The rate of MRSA HO-BSIs during the period with ASCs was 1.23 per 1,000 patient days. The rate was 1.28 in the follow-up period without the ASC program in place. The difference in incidence between the two periods was not statistically significant (P= 0.91). We conclude that ASCs and contact isolation of colonized patients may not be critical to reducing the incidence of HO-BSI caused by MRSA.

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