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Bacterial Infections
cohorting care of infected and colonized patients should have a substantial MRSA acquisition. Similarly, another study reported that having an ICU stay
impact on nosocomial transmission of MRSA.
31
of less than two days as well as being a trauma patient were significant
independent risk factors for MRSA acquisition in the ICU.
31
It is also important to maintain appropriate nurse–patient ratios because
studies suggest that understaffing and increased workload contribute to the
spread of micro-organisms in healthcare environments. This is probably a In order for healthcare professionals to
result of diminished adherence to hand hygiene and subsequent
succeed in preventing transmission of
patient–staff–patient transfer of pathogens. Unfortunately, few studies have
actually quantified the relationship between staffing levels and control of methicillin-resistant Staphylococcus
nosocomial infection in endemic hospital settings.
32
aureus (MRSA), they must understand
The final infection control measure with relatively strong evidence-based the epidemiology, pathogenesis, and
support is decreasing the length of hospital stays. Decreasing the length
routes of transmission of MRSA.
and/or frequency of hospital admission is thought to decrease the risk for
MRSA and other multidrug-resistant bacteria are endemic in the healthcare
It is also important to maintain
environment and serve as potential sources of outbreaks in these settings.
appropriate nurse–patient ratios Various protocols and guidelines have been developed to attempt to
prevent the development of resistant species of S. aureus and slow the
because studies suggest that
transmission of nosocomial MRSA. In order for healthcare professionals to
understaffing and increased workload succeed in preventing transmission of MRSA, they must understand the
epidemiology, pathogenesis, and routes of transmission of MRSA. It is
contribute to the spread of micro-
paramount that all staff understand the important role hand carriage plays
organisms in healthcare environments. in nosocomial transmission of these pathogens. Therefore, healthcare
providers must comply rigorously with proper hand hygiene. Other infection
nosocomial MRSA transmission. A number of studies support this concept. control measures such as cohorting care, maintaining appropriate staffing
For instance, a study evaluating the acquisition of MRSA in the ICU found levels, antibiotic stewardship, and decreasing lengths of hospital stays may
the length of an ICU stay to be a significant independent risk factor for be important in preventing nosocomial transmission of MRSA. ■
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58 US INFECTIOUS DISEASE 2007
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