Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities

Coia, John; Duckworth, G.; Edwards, David I.; Farrington, M.; Fry, Carole; Humphreys, H.; Mallaghan, C.; Tucker, D.

doi:10.1016/j.jhin.2006.01.001

Cited by 465 publications

(289 citation statements)

References 158 publications

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“…36 Furthermore, it should be considered that there is a premise that treatments should not be long, because of the possibility of bacterial resistance occurring. 1,37 In terms of available decolonization treatments, it is observed that they may involve a systemic treatment (by means of the oral administration of antibiotics) or topical treatment (using local medications or baths containing antibacterial agents). However, evidence is lacking for which type of treatment (topical or systemic) is more effective in this procedure.…”

Section: Discussionmentioning

confidence: 99%

“…In general, topical drugs are more commonly used as decontamination agents. 12,23,36,37 This occurs mainly because of the concern regarding the emergence of strains resistant to antimicrobial agents. 39 The main systemic antimicrobial agents used were vancomycin, rifamycin, fusidic acid and doxycycline.…”

Section: Discussionmentioning

confidence: 99%

“…12,25,32 In the main international guidelines -World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and the British Society for Antimicrobial Chemotherapy-regarding indications for use of systemic treatments for decolonization, the recommendation is that the drug be chosen based on consultation with the physicians specializing in infectious diseases and epidemiology in each individual hospital. 1,37 In terms of vancomycin, some guidelines contraindicate its use because of the possibility of increasing bacterial resistance to this particular drug. 36 It is highlighted that many patients exhibit low tolerance for vancomycin, and the following side effects are most common: dry mouth, unpleasant taste, stomatitis, nausea, abdominal pain, diarrhea, and flatulence.…”

Section: Discussionmentioning

confidence: 99%

“…12,[14][15][16][19][20]22,25,31,33 Corroborating this result, it is found that topical treatment using mupirocin is indicated by most international health guidelines, including those of the CDC and WHO. 1,5,[36][37]40 The CDC recommends using topical mupirocin alone in colonized patients for only short periods of time and for professionals who have an epidemiological relationship with the transmission of the organism. 1 On the other hand, the WHO considers the use of mupirocin and/ or chlorhexidine in MRSA carriers, but does not specify the indications, contraindications and time of usage.…”

Section: Discussionmentioning

confidence: 99%

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Descolonização de portadores de Staphylococcus aureus: indicações, vantagens e limitações

Oliveira

Paula

2012

Texto contexto - enferm.

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ABSTRACT:The objective of this article was to establish the main indications, advantages and limitations of the decolonization of patients with Staphylococcus aureus. An integrative literature review was performed on the LILACS, MEDLINE, Science Direct, SCOPUS and Isi Web of Knowledge databases for articles published after 1999. The main indications for decolonization pertained to high-risk patients (admitted to the ICU, post-operative, long stay, etcetera). The advantages were based on the eradication of the microorganism, reducing infection rates and the spread of the microorganism. The observed controversies were due to the possibility of increasing bacterial resistance and lack of scientific evidence regarding the effectiveness of the eradication of the colonizing microorganism, as well as reducing infection rates. Thus, it was observed that decolonization should not be indicated routinely; rather, it should only be recommended for patients at risk and during outbreaks. DESCRIPTORS: Infection control. Methicillin-resistant Staphylococcus aureus. Cross infection. Bacterial drug resistance. DESCOLONIZAÇÃO DE PORTADORES DE STAPHYLOCOCCUS AUREUS:INDICAÇÕES, VANTAGENS E LIMITAÇÕES RESUMO: O objetivo deste artigo foi estabelecer as principais indicações, vantagens e limitações da descolonização de pacientes portadores de Staphylococcus aureus. Procedeu-se a uma revisão integrativa da literatura, com busca de artigos nas bases de dados LILACS, MEDLINE, Science Direct, SCOPUS e Isi Web of Knowledge, e em publicações a partir de 1999. As principais indicações encontradas foram direcionadas aos pacientes considerados de alto risco (admitidos em UTI, submetidos à cirurgia, com longa permanência, etc.). As vantagens fundamentaram-se na erradicação do microrganismo, redução da taxas de infecção e na disseminação destes. As controvérsias se deram pela possibilidade do aumento da resistência bacteriana e pela falta de evidências científicas sobre a eficácia da eliminação do microrganismo colonizante e da redução da taxa de infecção. Observou-se que a descolonização não deve ser indicada como rotina, mas, sim, deve ser recomendada apenas para pacientes de risco e durante surtos. DESCRITORES: Controle de infecções.Staphylococcus aureus resistente à meticilina. Infecção hospitalar. Farmacorresistência bacteriana. DESCOLONIZACIÓN DE PORTADORES DE STAPHYLOCOCCUS AUREUS: INDICACIONES, VENTAJAS Y LIMITACIONES RESUMEN:El objetivo fue establecer las principales indicaciones, ventajas y limitaciones de la descolonización de los pacientes infectados por Staphylococcus aureus. Se realizó una revisión integrativa de literatura, buscando artículos, publicados a partir de 1999, en las bases de datos LILACS, MEDLINE, Science Direct, SCOPUS y el ISI Web of Knowledge. Las principales indicaciones fueron dirigidas a los pacientes de alto riesgo (ingresados en la UCI, sometidos a cirugía, con una estancia de larga duración, etc), los beneficios se fundamentaron en la erradicación y reducción de la propagación de microrganismos y la reducción ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Descolonização de portadores de Staphylococcus aureus: indicações, vantagens e limitações

Oliveira

Paula

2012

Texto contexto - enferm.

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“…1 Several international organizations have developed guidelines for prevention and control of MRSA, [2][3][4] namely patient isolation or cohorting, contact precautions, active patient screening at admission, decolonization, and environmental decontamination.…”

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confidence: 99%

Endemic methicillin-resistant Staphylococcus aureus: Nurses' risk perceptions and attitudes

Pedro

Uva²,

Pina³

2014

American Journal of Infection Control

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Dissemination of methicillin-resistant Staphylococcus aureus (MRSA) remains one of the most difficult challenges for prevention, control, and treatment of health careeassociated infections. A survey and interviews were conducted on nurses from a hospital center. We found that most nurses' perceived risk of acquiring MRSA related to themselves (72%), other nurses (88.5%), and patients (97.8%). This perception influences attitudes, leading to compliance with the existing recommendations.Copyright Ó 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.In Portugal, methicillin-resistant Staphylococcus aureus (MRSA) is endemic in most hospitals, with resistance rates >49% in cerebrospinal fluid and blood samples. 1 Several international organizations have developed guidelines for prevention and control of MRSA, 2-4 namely patient isolation or cohorting, contact precautions, active patient screening at admission, decolonization, and environmental decontamination.Full adoption of guidelines for prevention of cross infection depends on the awareness of the guidelines and risk perception related to the presence of MRSA by health care workers (HCWs). Behavioral theories suggest that a high-risk perception encourages individuals to adopt actions to reduce risk. 5,6 METHODS We conducted a cross-sectional study to determine perception and attitudes in relation with risk of exposure to MRSA. The study included nurses from 10 clinical units in a teaching medical center in Lisbon, which is composed of 4 hospital sites, though only 2 were used to conduct the study, in old buildings with wards of 4 beds and very limited isolation facilities. Wards with patients with more risk factors for acquiring MRSA and where surveillance of MRSA has been in place longer were selected.We intended to identify nurses' knowledge about the MRSA chain of transmission and nurses' perception of risks related to acquisition and transmission of MRSA for themselves, other nurses, and patients. We also identified how knowledge and perception are reflected in practices described by HCWs.The study protocol was submitted for approval by the hospital board and ethics committee. Internal consistency was evaluated with the Kaiser-Meyer-Olkin test. 7 After factorial analysis the sentence about "MRSA isolation report in discharge and transfer forms" was categorized as "risk perception" for purposes of analysis. Following expert review, the questionnaire and semistructured interview guide were subjected to pilot testing on a sample of the study population and were modified accordingly.The self-assessed anonymous questionnaire was distributed to a sample of nurses from 3 intensive care units and 7 medical wards (MWs). Additionally, an interview was conducted with 1 nurse per unit, selected on a voluntary basis.The questionnaire was composed of 21 items: 6 assessed knowledge, 8 addressed risk perception, and 7 addressed attitudes. Knowledge questions were multiple choice, and risk perce...

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Impact of Electronic Alerts on Isolation Precautions for Patients With Multidrug-Resistant Bacteria

Kac¹,

Grohs²,

Durieux³

et al. 2007

Arch Intern Med

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Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities

Cited by 465 publications

References 158 publications

Descolonização de portadores de Staphylococcus aureus: indicações, vantagens e limitações

Descolonização de portadores de Staphylococcus aureus: indicações, vantagens e limitações

Endemic methicillin-resistant Staphylococcus aureus: Nurses' risk perceptions and attitudes

Impact of Electronic Alerts on Isolation Precautions for Patients With Multidrug-Resistant Bacteria

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