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dc.contributor.authorLai, Kwan Kew
dc.contributor.authorFontecchio, Sally A.
dc.contributor.authorMelvin, Zita S.
dc.contributor.authorBaker, Stephen P.
dc.date2022-08-11T08:09:11.000
dc.date.accessioned2022-08-23T16:20:29Z
dc.date.available2022-08-23T16:20:29Z
dc.date.issued2006-09-29
dc.date.submitted2008-05-05
dc.identifier.citationInfect Control Hosp Epidemiol. 2006 Oct;27(10):1018-24. Epub 2006 Aug 31. <a href="http://dx.doi.org/10.1086/507916">Link to article on publisher's site</a>
dc.identifier.issn0899-823X (Print)
dc.identifier.doi10.1086/507916
dc.identifier.pmid17006807
dc.identifier.urihttp://hdl.handle.net/20.500.14038/35291
dc.description.abstractOBJECTIVE: Colonized and infected inpatients are major reservoirs for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), and transient carriage of these pathogens on the hands of healthcare workers remains the most common mechanism of patient-to-patient transmission. We hypothesized that use of alcohol-based, waterless hand antiseptic would lower the incidence of colonization and/or infection with MRSA and VRE. METHODS: On June 19, 2001, alcohol hand antiseptic was introduced at the University campus and not the nearby Memorial campus of the University of Massachusetts Medical School (Worcester, MA), allowing us to evaluate the impact of this antiseptic on the incidence of MRSA and VRE colonization and infection. From January 1 through December 31, 2001, the incidence of MRSA colonization or infection was compared between the 2 campuses before and after the hand antiseptic was introduced. Its effect on VRE colonization and infection was only studied in the medical intensive care unit at the University campus. RESULTS: At the University campus, the incidence of MRSA colonization or infection decreased from 1.26 cases/1,000 patient-days before the intervention to 0.75 cases/1,000 patient-days after the intervention, for a 1.46-fold decrease (95% confidence interval, 1.04-2.58; P = .037). At the Memorial campus, the incidence of MRSA colonization or infection remained virtually unchanged, from 0.34 cases/1,000 patient-days to 0.49 cases/1,000 patient-days during the same period. However, a separate analysis of the University campus data that controlled for proximity to prevalent cases did not show a significant improvement in the rates of infection or colonization. The incidence of nosocomial VRE colonization or infection before and after the hand antiseptic decreased from 12.0 cases/1,000 patient-days to 3.0 cases/1,000 patient-days, a 2.25-fold decrease (P = .018). Compliance with rectal surveillance for detection of VRE was 86% before and 84% after implementation of the hand antiseptic intervention. The prevalences of VRE cases during these 2 periods were 25% and 29%, respectively (P = .017). CONCLUSIONS: Alcohol hand antiseptic appears to be effective in controlling the transmission of VRE. However, after controlling for proximity to prevalent cases (ie, for clustering), it does not appear to be more effective than standard methods for controlling MRSA. Further controlled studies are needed to evaluate its effectiveness.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17006807&dopt=Abstract ">Link to article in PubMed</a>
dc.relation.urlhttp://www.jstor.org/stable/10.1086/507916
dc.subjectAlcohols
dc.subjectAnti-Infective Agents, Local
dc.subjectCross Infection
dc.subjectEnterococcus
dc.subjectGram-Positive Bacterial Infections
dc.subjectHand
dc.subjectHumans
dc.subject*Methicillin Resistance
dc.subjectStaphylococcal Infections
dc.subjectStaphylococcus aureus
dc.subject*Vancomycin Resistance
dc.subjectInfectious Disease
dc.titleImpact of alcohol-based, waterless hand antiseptic on the incidence of infection and colonization with methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci
dc.typeJournal Article
dc.source.journaltitleInfection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
dc.source.volume27
dc.source.issue10
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1035&amp;context=infoservices&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/infoservices/36
dc.identifier.contextkey503917
refterms.dateFOA2022-08-23T16:20:29Z
html.description.abstract<p>OBJECTIVE: Colonized and infected inpatients are major reservoirs for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), and transient carriage of these pathogens on the hands of healthcare workers remains the most common mechanism of patient-to-patient transmission. We hypothesized that use of alcohol-based, waterless hand antiseptic would lower the incidence of colonization and/or infection with MRSA and VRE.</p> <p>METHODS: On June 19, 2001, alcohol hand antiseptic was introduced at the University campus and not the nearby Memorial campus of the University of Massachusetts Medical School (Worcester, MA), allowing us to evaluate the impact of this antiseptic on the incidence of MRSA and VRE colonization and infection. From January 1 through December 31, 2001, the incidence of MRSA colonization or infection was compared between the 2 campuses before and after the hand antiseptic was introduced. Its effect on VRE colonization and infection was only studied in the medical intensive care unit at the University campus.</p> <p>RESULTS: At the University campus, the incidence of MRSA colonization or infection decreased from 1.26 cases/1,000 patient-days before the intervention to 0.75 cases/1,000 patient-days after the intervention, for a 1.46-fold decrease (95% confidence interval, 1.04-2.58; P = .037). At the Memorial campus, the incidence of MRSA colonization or infection remained virtually unchanged, from 0.34 cases/1,000 patient-days to 0.49 cases/1,000 patient-days during the same period. However, a separate analysis of the University campus data that controlled for proximity to prevalent cases did not show a significant improvement in the rates of infection or colonization. The incidence of nosocomial VRE colonization or infection before and after the hand antiseptic decreased from 12.0 cases/1,000 patient-days to 3.0 cases/1,000 patient-days, a 2.25-fold decrease (P = .018). Compliance with rectal surveillance for detection of VRE was 86% before and 84% after implementation of the hand antiseptic intervention. The prevalences of VRE cases during these 2 periods were 25% and 29%, respectively (P = .017).</p> <p>CONCLUSIONS: Alcohol hand antiseptic appears to be effective in controlling the transmission of VRE. However, after controlling for proximity to prevalent cases (ie, for clustering), it does not appear to be more effective than standard methods for controlling MRSA. Further controlled studies are needed to evaluate its effectiveness.</p>
dc.identifier.submissionpathinfoservices/36
dc.contributor.departmentDepartment of Cell Biology
dc.contributor.departmentInformation Services, Academic Computing Services
dc.source.pages1018-24


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