REDUCTION OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) ACQUISITION BY IMPLEMENTATION OF INFECTION CONTROL TRAINING IN NURSING HOMES: A SINGAPORE EXPERIENCE

Abstract

Intro: Nursing home (NH) is prone to acquisition and transmission of infection which pose health risks to NH residents. Implementation of infection control (IC) program has shown to mitigate aquisition and transmission risks. Infectious Diseases Community Program (IDCP) is a project to enhance collaborations with NHs to develop, adapt, and implement relevant and appropriate processes related to infection control, prevention, and management. One of the objectives is to enhance infection control capabilities in NHs through trainings with the aim to reduce transmission of infection. In this study, we analyse the rate of new MRSA acquisition as a surrogate marker of nosocomial transmission. Methods: This study was approved by NHG domain specific review board (DSRB). Three-tier of IC education and trainings were conducted in six NHs in Singapore starting in 2018. Hospital records were reviewed. We compared the rate of new MRSA acquisition from 2015-2017 (baseline) and 2019-2020 (after training). The year 2018 was the wash-out period when NHs were undergoing the trainings.New MRSA acquisition is defined as person, previously screened negative for MRSA or not done, now has positive MRSA screening. Rate of new MRSA acquisition is defined as number of new MRSA acquisition per total number of MRSA screening. Findings: Total number of MRSA screening was 2299 (83%) in 2015-2017 and 1787 (75%) in 2019-2020.The rate of new MRSA acquisition was 14.3% in 2015- 2017 and 9.5% in 2019-2020. There was 33.6% (95% confidence interval, 20.8 to 44.2) reduction in the rate of new MRSA acquisition. Conclusion: The rate of new MRSA acquisition in NHs has significantly reduced after comprehensive infection control education and training.