Risk factors for the transmission of methicillin-resistant Staphylococcus aureus in an adult intensive care unit: fitting a model to the data

  • Hajo Grundmann
  • , Satoshi Hori
  • , Bob Winter
  • , Adriana Tami
  • , Daren J Austin

Research output: Contribution to journalArticleAcademicpeer-review

193 Citations (Scopus)

Abstract

Little is known about the amount of cross-transmission, the risk factors for infection, and the relative effectiveness of infection control procedures when methicillin-resistant Staphylococcus aureus (MRSA) infection occurs at highly endemic levels in intensive care units. A cohort study was done to identify exposures associated with cases that likely were the result of cross-transmission (i.e., occurring in clusters and with indistinguishable MRSA macrorestriction profiles). Fitting a simple stochastic model to the ascertained data allowed prediction of the effectiveness of infection control measures. Exposure to relative staff deficit (adjusted rate ratio, 1.05 independent; 95% confidence interval, 1.02-1.09) was the only factor significantly associated with potential transmission (P =.001). It was predicted that a 12% improvement in adherence to hand-hygiene policies might have compensated for staff shortage and prevented transmission during periods of overcrowding, shared care, and high workload but that this would be hard to achieve.

Original languageEnglish
Pages (from-to)481-488
Number of pages8
JournalThe Journal of Infectious Diseases
Volume185
Issue number4
DOIs
Publication statusPublished - 15-Feb-2002

Keywords

  • Cluster Analysis
  • Cross Infection/etiology
  • Humans
  • Intensive Care Units
  • Methicillin Resistance
  • Models, Biological
  • Risk Factors
  • Staphylococcal Infections/etiology
  • Staphylococcus aureus/drug effects

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