Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin- resistant enteroccoci (VRE) had been found to confer a 40% increased risk of acquisition, presumably through environmental contamination. These US authors conducted a retrospective cohort study of patients admitted to 10 intensive care units at a 750-bed academic medical center during an enhanced cleaning intervention (from September 1, 2006, through April 30, 2008; n = 9449) vs baseline (from September 1, 2003, through April 30, 2005; n = 8203) periods. The intervention consisted of targeted feedback using a black-light marker, cleaning cloths saturated with disinfectant via bucket immersion, and increased education regarding the importance of repeated bucket immersion during cleaning. Intensive care units included medical, cardiac, burn/trauma, general surgery, cardiac surgery, thoracic surgery, and neurosurgery units.
They found: "Acquisition of MRSA and VRE was lowered from 3.0% to 1.5% for MRSA and from 3.0% to 2.2% for VRE. Patients in rooms previously occupied by MRSA carriers had an increased risk of acquisition during the baseline (3.9% vs 2.9%) but not the intervention (1.5% vs 1.5%) period. In contrast, patients in rooms previously occupied by VRE carriers had an increased risk of acquisition during the baseline (4.5% vs 2.8%,) and intervention (3.5% vs 2.0%) periods."
The authors concluded: "Enhanced intensive care unit cleaning using the intervention methods may reduce MRSA and VRE transmission. It may also eliminate the risk of MRSA acquisition due to an MRSA-positive prior room occupant."
Fuente: Arch Intern Med 171(6):491-494, 28 March 2011