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To Isolate or Not to Isolate? Analysis of Data From the German Nosocomial Infection Surveillance System Regarding the Placement of Patients With Methicillin-Resistant Staphylococcus aureus in Private Rooms in Intensive Care Units

Published online by Cambridge University Press:  02 January 2015

Petra Gastmeier ,
Frank Schwab ,
Christine Geffers  and
Henning Rüden
Petra Gastmeier*
Affiliation:
Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany
Frank Schwab
Affiliation:
Institute of Hygiene, Free University Berlin, Berlin, Germany
Christine Geffers
Affiliation:
Institute of Hygiene, Free University Berlin, Berlin, Germany
Henning Rüden
Affiliation:
Institute of Hygiene, Free University Berlin, Berlin, Germany
*
Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Carl-Neuberg-Str. 1, 30 625 Hannover, Germany
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Abstract

Objective:

To investigate whether isolating patients with MRSA in private rooms in ICUs (or cohorting) is a protective factor for nosocomial MRSA infection.

Design:

Association between nosocomial MRSA infection rates and ICU structure and process parameters in the German Nosocomial Infection Surveillance System (KISS).

Setting:

Two hundred twelve ICUs participating in KISS in 2001.

Methods:

In June 2001, a structured questionnaire was sent to the participating ICUs regarding their preventive measures, their type and size, their patient-to-personnel ratios, and routine cultures. Univariate and multivariate analyses were conducted to identify risk factors for nosocomial MRSA infection.

Results:

The questionnaire was completed by 164 (77.4%) of the ICUs. These ICUs had 325 nosocomial MRSA infections in a 5-year period (1997 to 2001). The mean incidence density of nosocomial MRSA infections was 0.3/1,000 patient-days. Ninety-one ICUs (55.5%) did not register any nosocomial MRSA infections during the observation period. Forty-two ICUs had an incidence density of at least 0.3/1,000 patient-days (75th percentile). Surgical ICUs were found to be a risk factor for a nosocomial MRSA infection rate above this threshold. Multivariate analysis found surgical ICUs to be an independent predictor and isolation in private rooms (or cohorts) to be a protective factor (OR, 0.36; CI95, 0.17-0.79).

Conclusion:

Many (34.4%) of the German ICUs have not isolated MRSA patients in private rooms or cohorts, a procedure associated with lower MRSA infection rates in this study.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 2 , February 2004 , pp. 109 - 113
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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