Hand hygiene program: "Go for 100*". Whole impact (hospital cost, MRSA attack, nosocomial infections and device related infections).

Background: Nosocomial infections (NI) are significant cause of mortality and hospital costs. Annual costs have approximately estimated of US﹩6·8 billion in the USA. Hand hygiene is the most important measure to prevent NI reducing them a 30% on average and to reduce MRSA attack rate. There is spare information about this in middle income countries. The aim was to explore the impact of the program in hospital costs, nosocomial infections and MRSA attack rate and clonality. Methods & Materials: Program "Vamos por el CIEN-Go for 100" (CIEN Spanish acronif of infection control by integration and innovative strategies"): based on the WHO hand hygiene multimodal strategy but focalizing education and awareness for every hospital sector and adding periodically innovative strategies. Here weanalyze 2013-2015. Direct costs of this program were evaluated monthly. Active nosocomial infections surveillance was done. A collection of 43 S. aureus clinical isolates from pediatric patients (one isolate per patient) was collected from January 2012 to May 2015. Molecular genotyping assays. Pulsed-field gel electrophoresis (PFGE) in the S. aureus clinical isolates was performed. The DNA fragment patterns generated by PFGE were analyzed using NTsys program 2.0 with the Sorencen-Dice coefficient and the unweighted pair group method with an arithmetic mean (UPGMA) clustering system. Results: Over 1,000 sessions took place from 2013-2015, impacting more than 15,000 people, the consumption of BPA increased from 125L/month to 400L/month, 2400 posters were allocated, the cost of the program per year was $217,618 dlls. Hand hygiene compliance increased from 48% to 74%, NI decreased from 7.68 to 6.47/100 discharges (15.7%), and the MRSA attack from 8.3 to 2.13/100 discharges. High clonality among nosocomial isolates MRSA was found, suggesting the presence of clones scattered in hospital environment that can interfere with program strategies. Conclusion: Probably due to a better distribution of resources the program costs were lower than the year before the program (﹩3743031.7dlls). We also demostrate that in a middle income country a hand hygiene program can decrease in NI especially in S. aureus. Phylogenetic analysis showed that hand hygiene has a direct impact on the clonality of MRSA hospital origin. [ABSTRACT FROM AUTHOR]