Long-Term Control of Endemic Hospital-Wide Methicillin-Resistant Staphylococcus aureus (MRSA): The Impact of Targeted Active Surveillance for MRSA in Patients and Healthcare Workers

Objective. To evaluate the long‐term impact of successive interventions on rates of methicillin‐resistant Staphylococcus aureus (MRSA) colonization or infection and MRSA bacteremia in an endemic hospital‐wide situation. Design. Quasi‐experimental, interrupted time‐series analysis. The impact of the interventions was analyzed by use of segmented regression. Representative MRSA isolates were typed by use of pulsed‐field gel electrophoresis. Setting. A 950‐bed teaching hospital in Seville, Spain. Patients. All patients admitted to the hospital during the period from 1995 through 2008. Methods. Three successive interventions were studied: (1) contact precautions, with no active surveillance for MRSA; (2) targeted active surveillance for MRSA in patients and healthcare workers in specific wards, prioritized according to clinical epidemiology data; and (3) targeted active surveillance for MRSA in patients admitted from other medical centers. Results. Neither the preintervention rate of MRSA colonization or infe...