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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EAddenbrooke\u0027s Hospital in Cambridge, United Kingdom, once known for having high rates of Staphylococcus aureus bloodstream infections, has been able to significantly reduce rates of methicillin-susceptible S. aureus and methicillin-resistant S. aureus BSIs using a number of infection control interventions.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EScreening \u0026amp; Prevention\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EBacterial Infections Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EAddenbrooke\u0027s Hospital in Cambridge, United Kingdom, once known for having high rates of \u003Cem\u003EStaphylococcus aureus\u003C\/em\u003E bloodstream infections (BSIs), has been able to significantly reduce rates of methicillin-susceptible \u003Cem\u003ES. aureus\u003C\/em\u003E (MSSA) and methicillin-resistant \u003Cem\u003ES. aureus\u003C\/em\u003E (MRSA) BSIs using a number of infection control interventions under the lead of Infection Control Doctor Nick Brown, MD. Staff physician Theodore Gouliouris, MD, presented data from a study that showed a decline in MRSA and MSSA BSI rates that was driven by reductions in nosocomial infections.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe purpose of the study was to analyze trends of MSSA and MRSA BSIs according to onset (community vs hospital) and assess the impact of infection control interventions. The interventions were initiated over several years and included: starting a hand hygiene campaign (November 2004), establishing a vascular access team (January 2006), improving line care bundles (June 2006), screening all emergency (April 2007) and elective (January 2009) admissions for MRSA carriage, and routinely decolonizing all MRSA-positive patients (entire study period). This was a retrospective study in a tertiary referral university hospital setting with 1200 beds and 70,000 in-patient admissions per year. All \u003Cem\u003ES. aureus\u003C\/em\u003E bacteremia (SAB) episodes from January 2001 to December 2010 at Addenbrooke\u0027s Hospital were included. The number of episodes was converted to rates per 1000 bed days, which allowed comparison with other hospitals. Only the first episode of SAB per patient during the study period was analyzed. Patients were categorized according to onset: community onset (\u0026lt;48 hours from hospital admission) and nosocomial onset (\u226548 hours from hospital admission).\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThere were 1607 SAB episodes following deduplication; 861 (53.6%) MSSA, of which 437 (50.8%) were community onset and 424 (49.2%) were nosocomial onset, and 746 (46.4%) MRSA, of which 163 (21.8%) were community onset and 583 (78.2%) were nosocomial onset.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EMRSA rates started to decline in 2004, driven more by a reduction in nosocomial infections, with the largest decrease (53%) occurring during the 2006 to 2007 period. MSSA rates started to decline in 2006, driven again by reductions in nosocomial infections, with the largest decrease (59%) occurring during 2006\u20132007. Community-acquired infections remained stable over the same period (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). Hand washing affected MRSA transiently but not MSSA rates, while having a vascular access team and performing line care bundle had a large impact on decreases for both MRSA and MSSA. Extended MRSA screening may have contributed to the larger decline in MRSA infections. Potential confounders (hospital 1000 bed-day activity and number of blood cultures processed) did not influence results.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/12\/12\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Community Acquired Infection Rates.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1301648072\u0022 data-figure-caption=\u0022Community Acquired Infection Rates.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/12\/12\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/12\/12\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/12\/12\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12438\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003ECommunity Acquired Infection Rates.\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from T. Gouliouris, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EThe results of this study are limited by the fact that it was a retrospective, noncomparative study. There was also a lack of data regarding the MSSA molecular epidemiology in the hospital, the proportion of community-onset bacteremias that were health care-associated, and the proportion of nosocomial bacteremias that were line-related.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EDr. Gouliouris concluded from the study that local rates of nosocomial MSSA BSIs have declined since 2006, though not as markedly as those for MRSA. The establishment of a vascular access team and the implementation of line care bundles appear to have had the most impact toward reducing both nosocomial MRSA and MSSA BSIs. MRSA screening and decolonization likely accounted for the greater reductions that were achieved in MRSA BSIs compared with MSSA. Finally, MSSA-targeted interventions may be needed to achieve reductions that are comparable with those for MRSA BSIs.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2011 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/11\/12\/12.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmx5d\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmx5d\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}