Back to basics: hand hygiene and isolation

Lin Huang, G. Khai; Stewardson, Andrew J.; Lindsay Grayson, M.

Lee et al. ] recently published an ambitious prospective, multicentre, interventional cohort study comparing interventions aimed at reducing rates of MRSA clinical isolates across 10 hospitals in Europe. Hospitals were assigned to enhanced hand hygiene (using the WHO multimodal hand hygiene promotion programme), screening for colonization with contact precautions and decolonization (if needed), or both. The individual interventions were not effective in reducing MRSA rates during the study period. However, the combination of hand hygiene promotion and target screening resulted in a reduction of MRSA isolates of 12% per month. Importantly, these hospitals had relatively low baseline rates of MRSA infection -thus, whether these findings can be generalized to other settings with high MRSA rates is less clear. Furthermore, the brief intervention period of only 12 months may have contributed to the failure of enhanced hygiene to reduce MRSA rates, as a number of studies have demonstrated a time lag between hand hygiene improvement and changes in infection rates [16, 18, 28] .