Authors: (including presenting author): :
PANG YKC (1)(2), Chan WY(2), Wong YM(2), Lai WMY(1), Wong YM(1), Ma KW(2), Lee KY(1)(2)
Affiliation: :
(1)Infection Control Team, Hong Kong East Cluster
(2)Infection Control Team, Wong Chuk Hang Hospital
Keyword 2: :
Decolonization
Keyword 3: :
Infirmary Patients
Introduction: :
Relative frequent readmission to acute care settings is observed in an infirmary hospital among long-stayed patients with history of MRSA infections due to potential health declines and treatment needs. Although MRSA decolonization therapy is widely practiced, no active decolonization program formulated for the long-stayed patients in the hospital. A proactive MRSA decolonization therapy for long-stayed infirmary patients was introduced in Feb 2024.
Objectives: :
To reduce the MRSA carrier caseload in an infirmary hospital and decrease the number of readmission episodes to acute care settings among long-stay patients.
Methodology: :
A proactive decolonization therapy included 2% mupirocin nasal ointment and 4% chlorhexidine baths for 5 consecutive days was introduced. MRSA carriers were offered 2 cycles of therapy, which a preliminary trial identified as the most effective number of cycles back in Dec 2023. Two sets of screenings would be performed 48 hours after completion of the 2 cycles of therapy, with each set taken at 48-hour intervals.
Result & Outcome: :
A total of 26 patients recruited to join the therapy from Feb 2024 to Dec 2025. Successful MRSA clearance was achieved in 14 patients, yielding an overall success rate of 53.8%. Among the 14 patients with successful clearance, 35 readmission episodes to acute care settings were recorded a year prior to the program implementation. Following the implementation of the therapy a year after, the number of acute care readmission episodes decreased to 12, representing a 65.7% reduction in acute care readmissions. These findings suggest that the successful MRSA decolonization can effectively reduce both the MRSA case load and the frequency of acute care readmissions among long-stayed infirmary patients. The proactive MRSA decolonization therapy program significantly reduced acute care readmissions, indicating potential for improved patient care and outcomes. Although implementation of the therapy may initially increase burden in routine care practice, the resulting decrease in MRSA caseload and transfer-related workload (escort duties and Contact Precautions management) may possibly contribute in resource savings. Further investigation is warranted to explore the specific underlying causes of infection-related readmissions and to better understand the overall impact of MRSA decolonization therapy on these outcomes.
