Eradication of an epidemic methicillin-resistant Staphylococcus aureus (MRSA) from a geriatric university hospital : evidence from a 10-year follow-up

We report on a successful eradication of methicillin-resistant S. aureus (MRSA) after an epidemic in 1992 in the geriatric ward of a tertiary-care hospital. After identification of MRSA in seven patients, all patients and staff members in the geriatric ward underwent screening. A multifaceted intervention plan was implemented: contact isolation, optimization of infection control and decolonization of all MRSA carriers. Thirty-two patients and five staff members were found to be MRSA carriers. Twenty one of 32 (66%) patients and all five staff members were successfully decolonized. Seven of 32 (22%) patients died during the epidemic before decolonization. A couple was discharged with persisting MRSA colonization and two individuals were lost to follow-up. The eradication of the epidemic clone was proven by systematic screenings in 1995 and 1997. Since then, the strain has no longer been identified in our institution, based on epidemiological surveillance and molecular typing of all MRSA strains obtained from any specimen. This study provides strong evidence that long-term eradication of an MRSA epidemic in a hospital is feasible, and endemicity of MRSA after an outbreak can be avoided. The successful bundle approach for eradication of MRSA during an epidemic is expensive, but the long-term benefits likely outweigh the initial heavy use of resources.