TY  -  JOUR
AU  -  Stano, Paola
AU  -  Avolio, Manuela
AU  -  De Rosa, Rita
AU  -  Modolo, Maria Luisa
AU  -  Camporese, Alessandro
T1  -  Riduzione del tasso di infezioni da Staphylococcus aureus meticillino-resistente in terapia intensiva 
dopo l’implementazione di uno specifico bundle 
basato sui risultati di uno screening molecolare rapido
PY  -  2014
Y1  -  2014-01-01
DO  -  10.1716/1422.15742
JO  -  GIMPIOS
JA  -  Gimpios
VL  -  4
IS  -  1
SP  -  10
EP  -  14
PB  -  Il Pensiero Scientifico Editore
SN  -  1122-407X
Y2  -  2026/04/23
UR  -  http://dx.doi.org/10.1716/1422.15742
N2  -  Introduction. Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor for subsequent MRSA invasive infections, particularly in patients admitted to critical areas such as intensive care units (ICU). Earlier identification of MRSA nasal carriers is considered essential to limit the spread of resistant strains, to reduce MRSA infection rate, and, subsequently, length of hospital stay and treatment costs. We conducted a surveillance among patients admitted to our ICU and we assess here the effects of a specific MRSA bundle, based on rapid molecular screening for MRSA nasal carriage, nasal decolonization, contact precautions for patients MRSA colonized, on MRSA infections prevalence in our intensive care unit. Methods. An MRSA bundle was implemented in 2011 in our ICU. A total of 431 and of 577 nasal swabs were obtained from ICU patients at the admission respectively from April 2009 through December 2010 (pre-bundle period) and, after the bundle implementation, from January 2011 through December 2012 (post-bundle period) and analyzed by the rapid molecular test Xpert MRSA Assay (Cepheid). The pre-bundle period has been used to assess the rate of MRSA colonization in the ICU, the effectiveness and efficiency of the diagnostic system adopted and to assess the most appropriate intervention for colonized patients. All patients were followed during their whole ICU stay to determine whether they developed MRSA infection which was confirmed by a positive culture from sterile sites. Results. The MRSA rate reduced from a value of 2% (9 patients) in the pre-bundle period to 0,3% (2 patients) in the post-bundle period, with a total MRSA infection decrease of 100% in two consecutive semesters, between July 2011 and July 2012. Discussion. The analysis demonstrated a significant decline in MRSA infections following the introduction of the rapid molecular active surveillance and the specific bundle in our ICU. Admission rapid molecular nasal screening, instead of traditional methods, is essential for patient management and clinical outcome. It is sensitive and capable of providing to clinicians results in few hours, allowing MRSA-positive ICU patients who will more likely develop MRSA infections to be rapidly detected and managed appropriately.
ER  -