[in Japanese]

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　 This ecological study was performed in order to assess how changes in the internal medicine ward move to the new ward can influence diagnosis of incident methicillin-resistant Staphylococcus aureus （MRSA） and Clostridium difficile （CD）. The environment of the old wards and the new wards, were compared and correlated with a laboratory diagnosis of the aforementioned bacteria, six months before and after the intervention（ward move）. Additionally, index of hand hygiene, the total number of patient hospitalizations by ward group, number of patient samples submitted and MRSA and CD incidence rate per 1000 patients （detection index） were analyzed. As a result of the move, the new wards were significantly re-designed with respect to occupied bed area, passage width, and location of staff station. After the ward move, hand hygiene index decreased in both the internal medicine ward and the critical care ward. There was no significant change in the total number of patient hospitalizations or number of submitted patient specimens where MRSA was diagnosed before and after the ward move.　 124 isolates of incident MRSA were diagnosed in the internal medicine wards before the move to the new ward, compared with 90 isolates after the intervention. The MRSA detection index was 0.74 before the move to the new ward and 0.54 after the move and while a significant decrease was observed（p＝0.02）.　 Additionally, prior to the intervention, the number of MRSA isolates diagnosed in the internal medicine wards was 45（detection index was 0.73）, compared with 24 isolates（detection index was 0.41） after the intervention and this was statistically significant（p＝0.04）. There was no statistically significant difference observed in the number of isolates of CD（38 isolates; detection index was 0.26） before the move for either ward setting, when compared with after the move（22 isolates; detection index was 0.14）（p＝0.07）. In summary, we believe that improvement in the internal medical ward environment is an important factor in reducing incidence of MRSA but not CD infection.

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[in Japanese]

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