Modelling the impact of antibiotic use and infection control practices on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus: A time-series analysis

Mamoon A. Aldeyab, Dominique I. Monnet, José María López-Lozano, Carmel M. Hughes, Michael G. Scott, Mary P. Kearney, Fidelma A. Magee, James C. Mcelnay

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen worldwide. A wide range of factors have been suggested to influence the spread of MRSA. The objective of this study was to evaluate the effect of antimicrobial drug use and infection control practices on nosocomial MRSA incidence in a 426-bed general teaching hospital in Northern Ireland. Methods: The present research involved the retrospective collection of monthly data on the usage of antibiotics and on infection control practices within the hospital over a 5 year period (January 2000-December 2004). A multivariate ARIMA (time-series analysis) model was built to relate MRSA incidence with antibiotic use and infection control practices. Results: Analysis of the 5 year data set showed that temporal variations in MRSA incidence followed temporal variations in the use of fluoroquinolones, third-generation cephalosporins, macrolides and amoxicillin/clavulanic acid (coefficients = 0.005, 0.03, 0.002 and 0.003, respectively, with various time lags). Temporal relationships were also observed between MRSA incidence and infection control practices, i.e. the number of patients actively screened for MRSA (coefficient = -0.007), the use of alcohol-impregnated wipes (coefficient = -0.0003) and the bulk orders of alcohol-based handrub (coefficients = -0.04 and -0.08), with increased infection control activity being associated with decreased MRSA incidence, and between MRSA incidence and the number of new patients admitted with MRSA (coefficient = 0.22). The model explained 78.4% of the variance in the monthly incidence of MRSA. Conclusions: The results of this study confirm the value of infection control policies as well as suggest the usefulness of restricting the use of certain antimicrobial classes to control MRSA.

LanguageEnglish
Pages593-600
Number of pages8
JournalJournal of Antimicrobial Chemotherapy
Volume62
Issue number3
DOIs
Publication statusPublished - 1 Sep 2008
Externally publishedYes

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Methicillin-Resistant Staphylococcus aureus
Infection Control
Anti-Bacterial Agents
Incidence
Alcohols
Amoxicillin-Potassium Clavulanate Combination
Northern Ireland
Drug and Narcotic Control
Fluoroquinolones
Macrolides
Cephalosporins
Teaching Hospitals
General Hospitals

Cite this

Aldeyab, Mamoon A. ; Monnet, Dominique I. ; López-Lozano, José María ; Hughes, Carmel M. ; Scott, Michael G. ; Kearney, Mary P. ; Magee, Fidelma A. ; Mcelnay, James C. / Modelling the impact of antibiotic use and infection control practices on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus : A time-series analysis. In: Journal of Antimicrobial Chemotherapy. 2008 ; Vol. 62, No. 3. pp. 593-600.
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Modelling the impact of antibiotic use and infection control practices on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus : A time-series analysis. / Aldeyab, Mamoon A.; Monnet, Dominique I.; López-Lozano, José María; Hughes, Carmel M.; Scott, Michael G.; Kearney, Mary P.; Magee, Fidelma A.; Mcelnay, James C.

In: Journal of Antimicrobial Chemotherapy, Vol. 62, No. 3, 01.09.2008, p. 593-600.

Research output: Contribution to journalArticle

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T1 - Modelling the impact of antibiotic use and infection control practices on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus

T2 - Journal of Antimicrobial Chemotherapy

AU - Aldeyab, Mamoon A.

AU - Monnet, Dominique I.

AU - López-Lozano, José María

AU - Hughes, Carmel M.

AU - Scott, Michael G.

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AU - Magee, Fidelma A.

AU - Mcelnay, James C.

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N2 - Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen worldwide. A wide range of factors have been suggested to influence the spread of MRSA. The objective of this study was to evaluate the effect of antimicrobial drug use and infection control practices on nosocomial MRSA incidence in a 426-bed general teaching hospital in Northern Ireland. Methods: The present research involved the retrospective collection of monthly data on the usage of antibiotics and on infection control practices within the hospital over a 5 year period (January 2000-December 2004). A multivariate ARIMA (time-series analysis) model was built to relate MRSA incidence with antibiotic use and infection control practices. Results: Analysis of the 5 year data set showed that temporal variations in MRSA incidence followed temporal variations in the use of fluoroquinolones, third-generation cephalosporins, macrolides and amoxicillin/clavulanic acid (coefficients = 0.005, 0.03, 0.002 and 0.003, respectively, with various time lags). Temporal relationships were also observed between MRSA incidence and infection control practices, i.e. the number of patients actively screened for MRSA (coefficient = -0.007), the use of alcohol-impregnated wipes (coefficient = -0.0003) and the bulk orders of alcohol-based handrub (coefficients = -0.04 and -0.08), with increased infection control activity being associated with decreased MRSA incidence, and between MRSA incidence and the number of new patients admitted with MRSA (coefficient = 0.22). The model explained 78.4% of the variance in the monthly incidence of MRSA. Conclusions: The results of this study confirm the value of infection control policies as well as suggest the usefulness of restricting the use of certain antimicrobial classes to control MRSA.

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