The Analysis of the Impact of a Mild, Low-iodine, Lotion Soap on the Reduction of Nosocomial Methicillin-ResistantStaphylococcus aureus:A New Opportunity for Surveillance by Objectives

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Abstract
A significant unremitting increase in the incidence of nosocomial methicillin-resistantStaphylococcus aureus(MRSA) infections in a 500-bed acute care community teaching hospital prompted reevaluation of the efficacy of the infection control measures used. A well-accepted, low-iodine, antimicrobial soap was used to replace a liquid natural handsoap in two areas with the highest incidence of MRSA—the intensive care unit, and a medical division.Over a two-year period, an analysis was made of the effect of soap replacement on nosocomial infections and pathogens. Soap changeover occurred at the midpoint of the two-year period. From year to year, the nosocomial MRSA rate decreased 80% (ttest,P=0.005). Other pathogens that demonstrated a dramatic decrease included methicillin-sensitiveStaphylococcus aureus(MSSA), infections where no pathogens were isolated, and various gram-negative infections. Categories of nosocomial infections that decreased included surgical wound infections, primary bacteremias, and respiratory tract infections. The overall nosocomial infection rate of the two combined areas decreased 21.5%, representing a year-to-year savings of $109,500. As a result, the decision was made to install the low-iodine hand-soap permanently at all sinks within the hospital.