Background
We analyzed time series data to investigate factors that contributed to the gradual
decrease and eventual eradication of methicillin-resistant Staphylococcus aureus (MRSA) from our neonatal intensive care unit (NICU).
Methods
A multivariate adjusted autoregressive integrated moving average (ARIMA) model was
used for time series analyses of monthly MRSA incidence density rates and their predictors
in the NICU from July 2003 to July 2009.
Results
Based on our ARIMA (0,1,1), which is a nonseasonal and nonstationary moving average
model, the monthly pooled mean of the amount of alcohol-based hand sanitizer used
for 1 patient per day (lag time, 0 month; P = .011) was the only factor significantly associated with the MRSA incidence density
rates. MRSA colonization pressure, patient-to-nurse ratios, and bed occupancy rates
were not associated with MRSA acquisition in the NICU. Active surveillance, which
had been practiced since the late 1980s, alone was not sufficient to control the spread
of MRSA until it was accompanied by enhanced hand hygiene.
Conclusion
Increasing the use of alcohol-based hand sanitizers by improving accessibility and
providing periodic hand hygiene training sessions to health care workers is strongly
recommended for decreasing the risk of MRSA acquisition among neonates in NICU settings.
Key Words
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Article Info
Publication History
Published online: April 05, 2010
Identification
Copyright
© 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
