Efficacy of patient isolation for the control of MRSA in the acute hospital setting: a systematic review

Abstract

The aim of the study was to critically review the best available literature that investigates the role of patient isolation in the minimisation of the nosocomial transmission of methicillin resistant Staphylococcus aureus (MRSA). A systematic review of such studies was undertaken. Eight articles were identified from electronic and hand searches as potentially meeting the inclusion criteria for this review. Two articles that did not meet the inclusion/exclusion criteria and one that did not meet the threshold quality score were excluded from the review. This paper is therefore a systematic review of five articles. One study reported no difference between standard care and protective isolation, while two studies reported a decrease in MRSA isolates in patients who were cared for using Universal Precautions and modified isolation respectively. However, the results of only one of the two studies achieved a statistical significance. Poor compliance with isolation precautions was reported amongst staff compared to family and visitors in the other two studies. Controlling the spread of MRSA is one of the most pressing infection control issues facing health service clinicians and administrators. This systematic review indicates that there is little conclusive evidence to validate isolation of patients with MRSA, although it is common clinical practice. No firm conclusions can be drawn from this review as the findings are based on single studies with small sample sizes. Well designed trials with large sample sizes are therefore a priority for the development of evidence based policies.