期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 177, 期 11, 页码 1306-1313出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kws380
关键词
Bayesian inference; data augmentation; infection control; Markov chain Monte Carlo; methicillin-resistant Staphylococcus aureus; patient isolation
资金
- European Community (Mastering Hospital Antimicrobial Resistance (MOSAR) network [LSHP-CT-2007-037941]
- Oak Foundation
- Wellcome Trust of Great Britain (Major Overseas Programme, Thailand Unit Core Grant)
- United Kingdom Department of Health
- MRC [MC_U105260556] Funding Source: UKRI
- Medical Research Council [MC_U105260556] Funding Source: researchfish
Infection control for hospital pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) often takes the form of a package of interventions, including the use of patient isolation and decolonization treatment. Such interventions, though widely used, have generated controversy because of their significant resource implications and the lack of robust evidence with regard to their effectiveness at reducing transmission. The aim of this study was to estimate the effectiveness of isolation and decolonization measures in reducing MRSA transmission in hospital general wards. Prospectively collected MRSA surveillance data from 10 general wards at Guys and St. Thomas hospitals, London, United Kingdom, in 20062007 were used, comprising 14,035 patient episodes. Data were analyzed with a Markov chain Monte Carlo algorithm to model transmission dynamics. The combined effect of isolation and decolonization was estimated to reduce transmission by 64 (95 confidence interval: 37, 79). Undetected MRSA-positive patients were estimated to be the source of 75 (95 confidence interval: 67, 86) of total transmission events. Isolation measures combined with decolonization treatment were strongly associated with a reduction in MRSA transmission in hospital general wards. These findings provide support for active methods of MRSA control, but further research is needed to determine the relative importance of isolation and decolonization in preventing transmission.
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