Methods: A 6-month prospective study of CHG on 4 medical wards was conducted from June 2 – December 2, 2014, with 2 wards serving as controls, at an urban, academic hospital in Vancouver, Canada. All nosocomial isolates of methicillin-resistant Staphylococcus aureus (MRSA) from any clinical site [>3 days after admission or ≤3 days with a previous admission in the past 4 weeks], as well as all blood cultures positive for methicillin-susceptible Staphylococcus aureus (MSSA) identified >3 days after admission were included. For patients with multiple isolates, only the first isolate was tested. An in-house developed real-time PCR for the qacA/B and smr genes was utilized. Statistical analysis was based on Fisher’s exact test.
Results: 21 S. aureus isolates were identified during the study period, including 19 MRSA and 2 MSSA. Of the 21 isolates, 6 were recovered from the intervention wards and 15 from the control wards. One MRSA isolate (sputum) was positive for qacA/B and 1 MSSA isolate (blood) was positive for smr on the CHG intervention wards. For patients on the intervention unit, median time to identification of a nosocomial MRSA was 7 days (estimated time of potential exposure to CHG use on the unit). No qacA/B or smr positive isolates were identified on the control wards (2/6 vs 0/15, p=0.07).
Conclusion: No significant difference in the detection of qacA/B and smr genes were identified in S. aureus recovered from the intervention wards utilizing CHG, despite a compliance of 62% over a 6-month period. However, continued monitoring for resistance is required, particularly for non-ICU settings in which selection of resistant strains may theoretically occur due to the likelihood of suboptimal compliance.
C. F. Lowe,
B. Sidhu, None
A. Sharma, None
W. Jang, None
A. Wong, None
V. Leung, None
S. Champagne, None
E. Lloyd-Smith, Sage Products: Investigator , Research grant
M. G. Romney, Sage Products: Investigator , Research grant