Authors (including presenting author) :
Chiu GCS(1), Chow VCY (1)(3), Lee ALH (3) , MUNG MMK(2), Lui GCY (2) , Leung TK(1), Wong PY(1), Ip SY(1), Liu HL (1), Yuen CPS(1), Cheung MML(1), TangHM(1)
Affiliation :
(1) Infection control Team, Prince of Wales hospital (2) Department of Medicine and Therapeutics, Prince of Wales Hospital (3) Department of Microbiology, Prince of Wales Hospital
Keyword 2: :
MRSA decolonization
Introduction :
Methicillin-resistant Staphylococcus aureus (MRSA) remains a major cause of nosocomial infections, including bacteraemia, pneumonia, and skin and soft tissue infections. MRSA infections are associated with prolonged hospital stays and increased mortality. Colonization is far more prevalent than clinical infection and serves as a reservoir for transmission. Effective control requires a bundled strategy comprising active surveillance, decolonization, strict hand hygiene, contact precautions, and antimicrobial stewardship.
Objectives :
This initiative aimed to reduce nosocomial transmission of MRSA and minimize bacterial load among colonized patients by (1) provide decolonization regimes to newly laboratory-detected MRSA cases, (2) introduce the Bare-below-elbow concept during patient care, and (3) reinforce peripheral vascular access device (PVAD) care to minimize MRSA bloodstream infections (BSI).
Methodology :
A central bathing team was established to perform MRSA decolonization baths. A training video was developed to enhance patient care assistants’ (PCA) skills in bed bathing, with encouragement for all PCA to view it. Promotion and training activities reinforced hand hygiene and the Bare-below-elbow concept. Workshops and infection control reminders were conducted to strengthen PVAD care practices.
Result & Outcome :
During the interventional period (October 2024 to September 2025), there was a reduction of 70 MRSA infection including 12 MRSA BSI compared with the non interventional period (October 2023 to September 2024). With the enhancement by post discharge call back of patients, the decolonization coverage from 47% increased to 87% in 3rd quarter of 2025. PVAD care compliance improved from 92% to 99.5%. Overall hand hygiene compliance increased from 92.3% to 94.6%, while Bare-below-elbow compliance ranged between 76.7% and 79.8%.
