MRSA control: a simple approach using triclosan antiseptic wash

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) had become endemic in a regional hospital. Active surveillance and isolation with contact precautions proved to be disruptive, costly, resource intensive and had no measurable beneficial effect. A modified method using passive surveillance and isolation of only high-risk dispersers reduced the costs, but did not decrease rates of acquisition. Facility-wide redevelopment and the provision of air-conditioning also failed to affect the MRSA rates. A 'before-after' cross-sectional study compared MRSA infection rates on an orthopaedic ward before and after the introduction of Triclosan 1% antiseptic solution for staff handwashing and patient body washing. The rate after the intervention was then compared to the rate of MRSA infection during the same period in a separate ward (surgical ward) which continued to use Chlorhexidine Gluconate 4% antiseptic solution for staff handwashing and pre-operative patient body washing. Additionally, the MRSA rates in the intensive care unit (ICU) were compared before and after the Triclosan intervention.On the orthopaedic ward, MRSA infection rates for 13 months after the intervention were 68% lower than before the intervention. Patients in the orthopaedic ward were significantly (p < 0.0001) less likely to acquire an MRSA infection than patients in the surgical ward (RR:0.25; 95% CI = 0.13-0.48). A longstanding MRSA outbreak in ICU was terminated soon after the Triclosan intervention was introduced. The use of Triclosan 1% antiseptic solution was associated with a reduced incidence of healthcare acquired MRSA infection in this setting, and may be an economically feasible and effective alternative to stringent MRSA control methods.