Eradication of methicillin-resistant Staphylococcus aureus from a health center ward and associated nursing home

Background: Long-term health care facilities have been recognized as reserv oirs of multiresistant bacterial strains, especially methicillin-resistant Staphylococcus aureus (MRSA). Efforts to control MRSA in this setting usual ly have been only partially effective. We describe herein the eradication o f epidemic MRSA from a Finnish health care center ward and affiliated nursi ng home. Methods: The methods to control MRSA included (1) contact isolation precaut ions,(2) screening for asymptomatic carriage, (3) eradication of carriage, and (4) education of staff on hygienic measures. The first 6 patients with MRSA-positive Findings were referred without delay to the Infectious Diseas es Unit of the adjacent university hospital for eradication treatment. Late r, an isolation unit of 6 rooms was founded in the health care center, wher e the MRSA-colonized patients were nursed as a separate cohere until they, in succession, were referred to the Infectious Diseases Unit for decoloniza tion. Results: From May 20 through August 17, 1993, the epidemic MRSA strain was isolated from 8 long-term patients on the 40-bed ward of the health care ce nter, 4 of the 59 residents of the nursing home, and 1 member of the staff. Eradication of carriage was successful in all except 1 patient with dement ia, who was nursed in contact isolation in the health care center until his death 21 months later. Conclusions: It is possible to eradicate MRSA from a long-term health care facility even after 13 cases by applying strict control measures. Our exper ience may be valuable in the future decision-making process for control of new and more challenging multiresistant bacterin, eg, vancomycin-resistant strains of MRSA.