{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:18:58Z","timestamp":1762867138150},"reference-count":34,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T00:00:00Z","timestamp":1496620800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec id=\"S0899823X17000812_abs1\" sec-type=\"general\"><jats:title>OBJECTIVE<\/jats:title><jats:p>We examined the impact of methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) guidelines in Qu\u00e9bec adult hospitals from January 1, 2006, to March 31, 2015, by examining the incidence rate reduction (IRR) in healthcare-associated MRSA bloodstream infections (HA-MRSA), using central-line associated bloodstream infections (CLABSIs) as a comparator.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X17000812_abs2\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>In this study, we utilized a quasi-experimental design with Poisson segmented regression to model HA-MRSA and CLABSI incidence for successive 4-week surveillance segments, stratified by teaching status. We used 3 distinct periods with 2 break points (April 1, 2007, and January 3, 2010) corresponding to major MRSA guideline publications and updates.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X17000812_abs3\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>Over the study period, HA-MRSA incidence decreased significantly in adult teaching facilities but not in nonteaching facilities. Prior to MRSA guideline publication (2006\u20132007), HA-MRSA incidence decrease was not significant (<jats:italic>P<\/jats:italic>=.89), while CLABSI incidence decreased by 4% per 4-week period (<jats:italic>P<\/jats:italic>=.05). After the publication of guidelines (2007\u20132009), HA-MRSA incidence decreased significantly by 1% (<jats:italic>P<\/jats:italic>=.04), while no significant decrease in CLABSI incidence was observed (<jats:italic>P<\/jats:italic>=.75). HA-MRSA and CLABSI decreases were both significant at 1% for 2010\u20132015 (<jats:italic>P<\/jats:italic>&lt;.001 and <jats:italic>P<\/jats:italic>=.01, respectively). These decreases were gradual rather than sudden; break points were not significant. Teaching facilities drove these decreases.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X17000812_abs4\" sec-type=\"conclusion\"><jats:title>CONCLUSION<\/jats:title><jats:p>During the study period, HA-MRSA and CLABSI rates decreased significantly. In 2007\u20132009, the significant decrease in HA-MRSA rates with stable CLABSI rates suggests an impact from MRSA-specific guidelines. In 2010\u20132015, significant and equal IRRs for HA-MRSA and CLABSI may be due to the continuing impact of MRSA guidelines, to the impact of new interventions targeting device-associated infections in general by the 2010\u20132015 Action Plan, or to a combination of factors.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic> 2017;38:840\u2013847<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2017.81","type":"journal-article","created":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T05:10:21Z","timestamp":1496639421000},"page":"840-847","source":"Crossref","is-referenced-by-count":6,"title":["Hospital-Acquired Methicillin-Resistant <i>Staphylococcus aureus<\/i> Bloodstream Infections in Qu\u00e9bec: Impact of Guidelines"],"prefix":"10.1017","volume":"38","author":[{"given":"Lynne","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise","family":"Fortin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claude","family":"Tremblay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muleka","family":"Ngenda-Muadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Garenc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Moisan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmin","family":"Villeneuve","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Quach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for SPIN-BACC and SPIN-SARM","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2017,6,5]]},"reference":[{"key":"S0899823X17000812_ref13","unstructured":"Minist\u00e8re de la Sant\u00e9 et des Services sociaux du Qu\u00e9bec (MSSS). Prevention and control of nosocomial infections\u2014Action Plan 2010-2015 progress of work: summary and highlights. In: sociaux SedS, ed. Quebec: Gouvernement du Qu\u00e9bec; 2011."},{"key":"S0899823X17000812_ref12","unstructured":"Minist\u00e8re de la Sant\u00e9 et des Services sociaux (MSSS). Plan d\u2019action sur la pr\u00e9vention et le contr\u00f4le des infections nosocomiales 2006\u20132009. In: sociaux SedS, ed. Quebec: Gouvernement du Qu\u00e9bec; 2006."},{"key":"S0899823X17000812_ref4","first-page":"331","article-title":"The reduction of nosocomial MRSA infection in Germany: an analysis of data from the Hospital Infection Surveillance System (KISS) between 2007 and 2012","volume":"111","author":"Meyer","year":"2014","journal-title":"Deutsches Arzteblatt Int"},{"key":"S0899823X17000812_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2010.07.007"},{"key":"S0899823X17000812_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu508"},{"key":"S0899823X17000812_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2013.09.002"},{"first-page":"55","volume-title":"Central Venous Catheter-Associated Bloodstream Infections in Intensive Care units in Canadian Acute-Care Hospitals: Surveillance Report January 1, 2006 to December 31, 2006 and January 1, 2009 to December 31, 2011","year":"2014","key":"S0899823X17000812_ref9"},{"key":"S0899823X17000812_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2011.01.003"},{"key":"S0899823X17000812_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(01)01112-3"},{"key":"S0899823X17000812_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.150"},{"key":"S0899823X17000812_ref3","first-page":"1970","article-title":"National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011","volume":"173","author":"Dantes","year":"2013","journal-title":"JAMA Internal Med"},{"volume-title":"Guide to the elimination of catheter-associated urinary tract infections (CAUTIs)","year":"2008","key":"S0899823X17000812_ref32"},{"key":"S0899823X17000812_ref27","doi-asserted-by":"publisher","DOI":"10.1136\/jech.50.Suppl_1.S12"},{"key":"S0899823X17000812_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2011.04.008"},{"key":"S0899823X17000812_ref17","unstructured":"Surveillance des bact\u00e9ri\u00e9mies nosocomiales sur cath\u00e9ters centraux aux soins intensifs. Institut national de sant\u00e9 publique du Qu\u00e9bec (INSPQ) website. https:\/\/www.inspq.qc.ca\/infections-nosocomiales\/spin\/bacc. Published 2016. Accessed April 4, 2017."},{"key":"S0899823X17000812_ref1","doi-asserted-by":"publisher","DOI":"10.1086\/345476"},{"key":"S0899823X17000812_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2014.11.014"},{"key":"S0899823X17000812_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2009.10.001"},{"key":"S0899823X17000812_ref16","unstructured":"Surveillance des bact\u00e9ri\u00e9mies \u00e0 Staphylococcus aureus r\u00e9sistant \u00e0 la m\u00e9thicilline (SARM). Institut national de sant\u00e9 publique du Qu\u00e9bec (INSPQ) website. https:\/\/www.inspq.qc.ca\/infections-nosocomiales\/spin\/sarm. Published 2015. Accessed May 23, 2016."},{"key":"S0899823X17000812_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2011.10.001"},{"key":"S0899823X17000812_ref30","doi-asserted-by":"publisher","DOI":"10.1086\/651091"},{"key":"S0899823X17000812_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.03.002"},{"key":"S0899823X17000812_ref11","unstructured":"Bact\u00e9ri\u00e9mies \u00e0 Staphylococcus aureus r\u00e9sistant \u00e0 la m\u00e9thicilline: r\u00e9sultats de surveillance. Institut national de sant\u00e9 publique du Qu\u00e9bec (INSPQ) website. https:\/\/www.inspq.qc.ca\/printpdf\/4087. Published 2015. Accessed April 4, 2017."},{"volume-title":"\u00c9tude sur les mesures de pr\u00e9vention et de contr\u00f4le du Staphylococcus aureus r\u00e9sistant \u00e0 la m\u00e9thicilline (SARM) appliqu\u00e9es dans les centres hospitaliers de soins aigus du Qu\u00e9bec","year":"2009","key":"S0899823X17000812_ref14"},{"key":"S0899823X17000812_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2011.04.011"},{"key":"S0899823X17000812_ref31","doi-asserted-by":"publisher","DOI":"10.1086\/600379"},{"key":"S0899823X17000812_ref2","doi-asserted-by":"publisher","DOI":"10.1086\/658940"},{"key":"S0899823X17000812_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12028"},{"key":"S0899823X17000812_ref18","doi-asserted-by":"publisher","DOI":"10.1086\/669074"},{"key":"S0899823X17000812_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2013.01.002"},{"key":"S0899823X17000812_ref28","doi-asserted-by":"publisher","DOI":"10.1136\/jech.50.Suppl_1.S3"},{"key":"S0899823X17000812_ref10","doi-asserted-by":"publisher","DOI":"10.5694\/mja13.10599"},{"key":"S0899823X17000812_ref33","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200109000-00011"},{"volume-title":"Surveillance des bact\u00e9ri\u00e9mies \u00e0 Staphylococcus aureus dans les centres hospitaliers de soins aigus du Qu\u00e9bec: protocole","year":"2013","key":"S0899823X17000812_ref21"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X17000812","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T17:14:00Z","timestamp":1555521240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X17000812\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,5]]},"references-count":34,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["S0899823X17000812"],"URL":"https:\/\/doi.org\/10.1017\/ice.2017.81","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"type":"print","value":"0899-823X"},{"type":"electronic","value":"1559-6834"}],"subject":[],"published":{"date-parts":[[2017,6,5]]}}}