Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-26T08:49:55.546Z Has data issue: false hasContentIssue false

The Analysis of the Impact of a Mild, Low-iodine, Lotion Soap on the Reduction of Nosocomial Methicillin-Resistant Staphylococcus aureus: A New Opportunity for Surveillance by Objectives

Published online by Cambridge University Press:  02 January 2015

Kim M. Onesko*
Affiliation:
Deaconess Hospital, St. Louis, Missouri
Eugene C. Wienke
Affiliation:
Deaconess Hospital, St. Louis, Missouri
*
CIGNA Health Plan, 1807 Park 270 Drive, St. Louis, MO 63146

Abstract

A significant unremitting increase in the incidence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections in a 500-bed acute care community teaching hospital prompted reevaluation of the efficacy of the infection control measures used. A well-accepted, low-iodine, antimicrobial soap was used to replace a liquid natural handsoap in two areas with the highest incidence of MRSA—the intensive care unit, and a medical division.

Over a two-year period, an analysis was made of the effect of soap replacement on nosocomial infections and pathogens. Soap changeover occurred at the midpoint of the two-year period. From year to year, the nosocomial MRSA rate decreased 80% (t test, P=0.005). Other pathogens that demonstrated a dramatic decrease included methicillin-sensitive Staphylococcus aureus (MSSA), infections where no pathogens were isolated, and various gram-negative infections. Categories of nosocomial infections that decreased included surgical wound infections, primary bacteremias, and respiratory tract infections. The overall nosocomial infection rate of the two combined areas decreased 21.5%, representing a year-to-year savings of $109,500. As a result, the decision was made to install the low-iodine hand-soap permanently at all sinks within the hospital.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Thomson, RL, Cabezudo, I, Wenzel, RP, Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med 1982;97:309317.Google Scholar
2.McDonald, PJ, Methicillin-resistant Staphylococci: A sign of the times? Med J Aust 1982;445446.Google Scholar
3.Gerken, MV, An outbreak of methicillin-resistant Staphylococcus aureus in a large medical center. Am Surg 1983;49:179181.Google Scholar
4.Locksley, RM, Cohen, ML, Quinn, TC, et al: Multiply antibiotic-resistant Staphylococcus aureus: Introduction, transmission, and evolution of nosocomial infection. Ann Intern Med 1982;97:317324.Google Scholar
5.Saravolatz, LD, Pohlod, DJ, Arking, LM, Community-acquired methicillin-resistant Staphylococcus aureus infections: A new source for nosocomial outbreaks. Ann Intern. Med 1982;97:325329.Google Scholar
6.Arrow, PM, Allyn, PA, Nichols, EM, et al: Control of methicillin-resistant Staphylococcus aureus in a burn unit: Role of nurse staffing. J Trauma 1982;22:954959.Google Scholar
7.Bartzokas, CA, Paton, JH, Gibson, MF, et al: Control and eradication of methicillin-resistant Staphylococcus aureus on a surgical unit. N Engl J Med 1984;311:14221425.Google Scholar
8.Jarvis, WR, White, JW, Munn, VP, et al: Nosocomial infection surveillance, 1983. MMWR CDC Surveitl Summ 1984;33:9SS21SS.Google Scholar
9.Wenzel, RP, Methicillin-resistant Staph. Conversations in Infection Control 1984;5(4).Google Scholar
10.Haley, RW, Hightower, AW, Khabbaz, RF, et al: The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals: Possible role of the house staff-patient transfer circuit. Ann Intern Med 1982;97:297308.Google Scholar
11.Thomson, RL, Cabezudo, I, Wenzel, RP, Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med 1982;97:309317.Google Scholar
12.Crossley, K, Landesman, B, Zaske, D, An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillfn and aminoglycosides. Infect Dis 1979;139:280287.Google Scholar
13.Berkleman, RL, Holland, BW, Anderson, RL, Increased bactericidal activity of dilute preparations Of povidone-iodine solutions. J Clin Microbiol 1982;15:635639.Google Scholar
14.Haley, CE, Marling-Cason, M, Smith, JW, et al: Bactericidal activity of antiseptics against methicillin-resistant Staphylococcus aureus. J Clin Microbiol, April 1982, pp 635639.Google Scholar
15.Gardner, IS, Bennett, JV, Scheckler, WE, et al: Surveillance of nosocomial infections. Proceedings of International Conference on Nosocomial Infections. CDC, Atlanta, GA, Aug 3-6, 1970.Google Scholar
16.Centers for Disease Control: Isolation techniques for use in hospitals. Government Printing Office, 1975.Google Scholar
17.Gardner, JS, Simmons, BP, Guidelines for isolation precautions in hospitals. Infect Control 1983;4:245315.Google Scholar
18.Haley, RW, Surveillance by objective: A new priority-directed approach to the control of nosocomial infections. Am J Infect Control 1985;13:7889.Google Scholar
19.Haley, RW, The “hospital epidemiologist” in US hospitals, 1976-1977: A description of the head of the infection surveillance and control program. Infect Control 1980;1:2132.Google Scholar
20.Haley, RW, Schaberg, DR, Von Allmen, SD, et al: Estimating the extra charges and prolongation of hospitalization due to nosocomial infections: A comparison of methods. J Infect Dis 1980;141:248257.Google Scholar
21.Haley, RW, Schaberg, DR, Crossley, KB, et al: Extra charges and prolongation of hospitalization due to nosocomial infections: A prospective inter-hospital comparison. Am J Med 1981;70:5158.Google Scholar
22.Pinner, RW, Haley, RW, Blumenstein, BA, et al: High cost of nosocomial infections. Infect Control 1982;3:143149.Google Scholar