Effectiveness of MRSA Preventive Measures in Healthcare Settings

FIGURE 1. PRISMA Flow Diagram (Moher et al. 2009)
Records identified through different
database searches (CINAHL,
MEDLINE, Academic Search
Complete and ERIC) n=490
Records after duplicates removed
n=280
Records screened n= 280
Records excluded based on title
and abstract screening (n=250)
Full-text articles
assessed for eligibility
(n=30)
Full text articles excluded with
reasons (n=15)
Not as a preventive intervention (n=8).
Interventions considering non-adult
patients (paediatrics, neonates) (n=3)
Not hospital based (n=4)
Studies included n=15
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Author
(Year) and
Country
Aim Research
Design
Data
Collection and
Instruments
Sample and
Setting
MRSA Preventive
Measures/Intervention
s
Outcomes Quality
Assessmen
t
Cheng et al.
(2014),
Hong Kong
To control
nosocomial
transmission of
methicillin-
resistant
Staphylococcus
aureus (MRSA)
in resource-
limited
healthcare
setting with
high
endemicity.
Retrospective
Study (n =
1600)
Specimens for
microbiologica
l investigation
and changes in
incidence rates
per 1000
patient
admissions,
per 1000
patient days
and per 1000
MRSA
positive days
All MRSA
positive
patients in a
1600 bed,
university
affiliated
hospital from
1st January
2004 to 31st
December
2012.
Three phase infection
control interventions:
first 48 months of
standard precautions,
second 24 months of
hand hygiene campaign
and 36 months of
contact precautions with
continuation of hand
washing and daily
bathing with 2%
chlorhexidine gluconate.
Incidence rates
of hospital
acquired MRSA
infections
Included in
the
Systematic
Review
Gerlich et al.
(2015),
Germany
To improve
hospital
hygiene for the
reduction of
impact
underlying
multi-drug
Prospective
Controlled
Multicenter
Study (n =
1000)
Questionnaires
and
documentation
s sheets for
recording
hygiene
measures
Administratio
n of a
multimodal
system of
hygiene
management
in eight acute
Administration of
HARMONIC
(Harmonized Approach
to avert Multidrug-
resistant Organisms and
Nosocomial Infections)
study comprising of
Screening rates
of MRSA, VRE
MRGN in
patients with
high risk,
frequency of
MRSA
Included in
the
Systematic
Review
Table 1: Data Extraction Table: Summary of Research Design and Study Outcomes (n = XYZ

Author
(Year) and
Country
Aim Research
Design
Data
Collection and
Instruments
Sample and
Setting
MRSA Preventive
Measures/Intervention
s
Outcomes Quality
Assessmen
t
resistant
infections in
healthcare
organizations
care hospitals written and regional
recommendations on for
antibiotic prescriptions
and prevention of
infections from
methicillin-resistant
Staphylococcus aureus
(MRSA), vancomycin-
resistant Enterococci
(VRE) and multi-
resistant Gram-negative
bacteria (MRGN).
decolonization,
level of
knowledge
among health
workers and
types of
antibiotics used
Gurieva,
Bootsma and
Bonten
(2013),
Netherlands
To assess the
effects and
costs of various
admission
screening
strategies to
control MRSA
infection
transmission
Case control
study
comprising
of multiple
scenario
analysis
using
Mathematic
Model based
study (n =
220, 000)
Mathematical
model to
assess effects
and costs and
different
screening
strategies and
identification
of critical
parameters
underlying
MRSA
transmission
prevention
Usage of a
dynamic
stochastic
model across
general and
intensive care
unit wards in
3 hospitals
and usage of a
mathematical
model to
assess effects
and costs and
different
Universal screening and
screening and isolation
of patients
Cost and effects
of different
MRSA
admission
screening
strategies
Included in
the
Systematic
Review
Table 1: Data Extraction Table: Summary of Research Design and Study Outcomes (n = XYZ

Author
(Year) and
Country
Aim Research
Design
Data
Collection and
Instruments
Sample and
Setting
MRSA Preventive
Measures/Intervention
s
Outcomes Quality
Assessmen
t
screening
strategies and
identification
of critical
parameters
underlying
MRSA
transmission
prevention
Harris et al.
(2013),
United
States
To assess
whether
wearing gloves
and gowns for
all patient
contact in the
ICU decreases
acquisition of
MRSA
infections
Cluster
Randomized
trial (n = 26,
180)
Collection of
microbial
swabs before
and after usage
of gloves and
gowns
Cluster
randomized
trial in
medical,
surgical and
ICU units of
20 hospitals
Usage of gloves and
gowns during entering
patient rooms
Incidences of
MRSA
infections
Included in
the
Systematic
Review
Harris et al.
(2015),
Singapore
To explore
association
between
antiseptic body
washes and
MRSA
infection
Cluster
crossover
study (n =
10, 936)
Prospective
cluster
crossover
study to
compare daily
octenidine
body washes
Cluster
crossover
study across 2
intensive care
units and 5
adult medical
units with
Daily octenidine
washing of patients with
soap and water
Rates of MRSA
infection
acquisition.
Included in
the
Systematic
Review
Table 1: Data Extraction Table: Summary of Research Design and Study Outcomes (n = XYZ

Author
(Year) and
Country
Aim Research
Design
Data
Collection and
Instruments
Sample and
Setting
MRSA Preventive
Measures/Intervention
s
Outcomes Quality
Assessmen
t
transmission with soap and
water and
MRSA
acquisition
inclusion of
10936
patients,
washed with
soap and
water
followed by
surveillance of
MRSA
infection
surveillance
Table 1: Data Extraction Table: Summary of Research Design and Study Outcomes (n = XYZ

Author
(Year) and
Country
Aim Research
Design
Data
Collection and
Instruments
Sample and
Setting
MRSA Preventive
Measures/Intervention
s
Outcomes Quality
Assessmen
t
Kohlenberge
t al. (2015),
Germany
To assess
screening and
control
measures of
MRSA
infections in
intensive care
units
Survey
Questionnair
e – Pre and
Post Survey
Study (n =
186)
Generalized
linear
regression
models on
association
between
MRSA cases
and survey
questionnaire
results
Pre and post
survey
analysis using
generalized
linear
regression
models and
survey
questionnaire
across 186
intensive care
units and
MRSA cases
occurring
from 2007 to
2008.
Universal admission
screening and
assessment on MRSA
incidence densities
MRSA
incidence
densities
Included in
the
Systematic
Review
Table 1: Data Extraction Table: Summary of Research Design and Study Outcomes (n = XYZ