Methicillin-resistant Staphylococcus aureus nosocomial acquisition and carrier state in a wound care center

Objective: To assess methicillin-resistant Staphylococcus aureus (MRSA) nos ocomial acquisition and carrier state in a wound care center. Design and Setting: The results of an intervention to control MRSA were com pared with those of historical controls at the wound care center of univers ity-based Hopital Broussais, Paris, France. Patients: Patients admitted for specific care of chronic ulcers and surgica l wounds. Main Outcome Measures: Incidence rates of MRSA carriers and acquisition in wounds. Results: Of 88 patients admitted during a 3-month preintervention period in 1993, 18 (21%) were MRSA carriers. Of 334 patients admitted in 1994 and 39 5 in 1996, 65 (19.5%) and 81 (20.5%) were MRSA carriers, respectively (P=.8 0). In 1993, 6 (9%) of 70 patients without MRSA acquired MRSA wound infecti ons; the corresponding numbers were 6 (2.2%) of 269 in 1994 and 3 (0.9%) of 314 in 1996. Despite that the number of MRSA carriers remained stable at a dmission to the wound care center, the rate of MRSA infections in wounds pe r 100 noncarriers decreased significantly between the preintervention perio d and subsequent pears: 1994 (P=.02) and 1996 (P=.002). Conclusions: Although our results are limited by the use of historical cont rols, they showed that simple infection control measures, such as the use o f soap and water and barrier precautions associated with staff education, s eemed to significantly reduce MRSA infection rates in patients with chronic skin breaks.