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Intervention to Reduce the Incidence of Methicillin-Resistant Staphylococcus aureus Skin Infections in a Correctional Facility in Georgia

Published online by Cambridge University Press:  02 January 2015

Susan H. Wootton ,
Kathryn Arnold ,
Holly A. Hill ,
Sigrid McAllister ,
Marsha Ray ,
Molly Kellum ,
Madie LaMarre ,
Mary Ellen Lane ,
Jasmine Chaitram  and
Susan Lance-Parker
...Show all authors
Susan H. Wootton*
Affiliation:
Centers for Disease Control and Prevention, Epidemiology Program Office, Division of Applied Public Health Training, Epidemic Intelligence Service Branch, Atlanta, Georgia Georgia Department of Human Resources, Division of Public Health, Atlanta, Georgia
Kathryn Arnold
Affiliation:
Georgia Department of Human Resources, Division of Public Health, Atlanta, Georgia
Holly A. Hill
Affiliation:
Centers for Disease Control and Prevention National Center for Infectious Diseases, Division of Healthcare Quality Promotion, Atlanta, Georgia
Sigrid McAllister
Affiliation:
Centers for Disease Control and Prevention National Center for Infectious Diseases, Division of Healthcare Quality Promotion, Atlanta, Georgia
Marsha Ray
Affiliation:
Georgia Department of Human Resources, Division of Public Health, Atlanta, Georgia
Molly Kellum
Affiliation:
Centers for Disease Control and Prevention National Center for Infectious Diseases, Division of Healthcare Quality Promotion, Atlanta, Georgia
Madie LaMarre
Affiliation:
Georgia Department of Corrections, Atlanta, Georgia
Mary Ellen Lane
Affiliation:
Georgia Department of Corrections, Atlanta, Georgia
Jasmine Chaitram
Affiliation:
Centers for Disease Control and Prevention National Center for Infectious Diseases, Division of Healthcare Quality Promotion, Atlanta, Georgia
Susan Lance-Parker
Affiliation:
Georgia Department of Human Resources, Division of Public Health, Atlanta, Georgia
Matthew J. Kuehnert
Affiliation:
Centers for Disease Control and Prevention National Center for Infectious Diseases, Division of Healthcare Quality Promotion, Atlanta, Georgia
*
6621 Fannin Street, Mail Code 3-2371, Houston, TX 77030-2399
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Abstract

Background and Objective:

In August 2001, a cluster of MRSA skin infections was detected in a correctional facility. An investigation was conducted to determine its cause and to prevent further MRSA infections.

Design:

Case-control study.

Setting:

A 200-bed detention center.

Patients:

A case was defined as a detainee with a skin lesion from which MRSA was cultured from July 24 through December 31, 2001. Case-patients were identified by review of laboratory culture results and by skin lesion screening through point-prevalence survey and admission examination. Controls were randomly selected from an alphabetized list of detainees.

Intervention:

Medical staff implemented measures to improve skin disease screening, personal hygiene, wound care, and antimicrobial therapy.

Results:

Sixteen cases were identified: 11, 5, and 0 in the preintervention, peri-intervention, and postintervention periods, respectively. Seven case-patients and 19 controls were included in the case-control study. On multivariable analysis, working as a dormitory orderly (OR, 9.8; CI95, 0.74-638; P= .10) and a stay of longer than 36 days (OR, 6.9; CI95, 0.65-128.2; P = .14) were the strongest predictors for MRSA skin infection. The preintervention, peri-intervention, and postintervention MRSA infection rates were 11.6, 8.8, and 0 per 10,000 detainee-days, respectively. The rate of MRSA skin infections declined significantly between both the preintervention and peri-intervention periods and the postintervention period (P < .01 for both comparisons).

Conclusions:

MRSA skin disease can become an emergent problem in a correctional facility. Interventions targeted at skin disease screening, appropriate antimicrobial treatment, and hygiene may decrease the risk of acquiring MRSA infection in correctional facilities.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 5 , May 2004 , pp. 402 - 407
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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