Methicillin-resistant Staphylococcus aureus (MRSA) in Europe: which infection control measures are taken?

Hansen, Sonja; Schwab, Frank J.; Asensio, Ángel; Carsauw, H; Heczko, Piotr B; Klavs, Irena; Lyytikäinen, Outi; Palomar, Mercedes; Riesenfeld-Orn, I.; Savey, Anne; Szilágyi, Emese; Valintėlienė, Rolanda; Fabry, J.; Gastmeier, Petra

doi:10.1007/s15010-010-0001-8

Cited by 37 publications

(15 citation statements)

References 18 publications

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“…For example, Hansen et al report a ratio of 8 single-patient rooms over 10 in French participating ICUs to a European survey on MRSA infection control measures. 28 We believe this ratio is consistent with the 70% adherence rate of French responders in our survey regarding the availability of single-patient rooms. Figures are similarly consistent between the two studies for other countries like Spain or Germany.…”

Section: Strength and Limitations Of The Studysupporting

confidence: 87%

A European survey of nosocomial infection control and hospital-acquired pneumonia prevention practices

Ricard

Conti

Boucherie

et al. 2012

Journal of Infection

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Section: Strength and Limitations Of The Studysupporting

confidence: 87%

A European survey of nosocomial infection control and hospital-acquired pneumonia prevention practices

Ricard

Conti

Boucherie

et al. 2012

Journal of Infection

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“…Substantial variation in MRSA control measures between European countries has been described [22]. Our study shows that the implemented control measures also differ considerably between ICUs within one country.…”

Section: Discussionmentioning

confidence: 69%

Screening and control of methicillin-resistant Staphylococcus aureus in 186 intensive care units: different situations and individual solutions

et al. 2011

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IntroductionControversy exists about the benefit of screening for prevention of methicillin-resistant Staphylococcus aureus (MRSA) in intensive care units (ICUs) and recent studies have shown conflicting results. The aim of this observational study was to describe and evaluate the association between MRSA incidence densities (IDs) and screening and control measures in ICUs participating in the German Nosocomial Infection Surveillance System.MethodsThe surveillance module for multidrug-resistant bacteria collects data on MRSA cases in ICUs with the aim to provide a national reference and a tool for evaluation of infection control management. The median IDs of MRSA cases per 1000 patient-days (pd) with the interquartile range (IQR) were calculated from the pooled data of 186 ICUs and correlated with parameters derived from a detailed questionnaire regarding ICU structure, microbiological diagnostics and MRSA screening and control measures. The association between questionnaire results and MRSA cases was evaluated by generalized linear regression models.ResultsOne hundred eighty-six ICUs submitted data on MRSA cases for 2007 and 2008 and completed the questionnaire. During the period of analysis, 4935 MRSA cases occurred in these ICUs; of these, 3928 (79.6%) were imported and 1007 MRSA cases (20.4%) were ICU-acquired. Median MRSA IDs were 3.23 (IQR 1.24-5.73), 2.24 (IQR 0.63-4.30) and 0.64 (IQR 0.17-1.39) per 1000 pd for all cases, imported and ICU-acquired MRSA cases, respectively. MRSA IDs as well as implemented MRSA screening and control measures varied widely between ICUs. ICUs performing universal admission screening had significantly higher MRSA IDs than ICUs performing targeted or no screening. Separate regression models for ICUs with different screening strategies included the incidence of imported MRSA cases, the type of ICU, and the length of stay in independent association with the number of ICU-acquired MRSA cases.ConclusionsThe analysis shows that MRSA IDs and structural parameters differ considerably between ICUs. In response, ICUs have combined screening and control measures in many ways to achieve various individual solutions. The incidence of imported MRSA cases might be helpful for consideration in the planning of MRSA control programmes.

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“…The vast majority reported a policy for contact/isolationprecautions for culture-positive patients, which is congruent with other studies that reported high use of barrier/isolation precautions for infected patients. 12,18,21 The presence of other MDRO-related infection control policies in our sample was low and may reflect wide variation in published recommendations on these interventions or their interpretation.…”

Section: Discussionmentioning

confidence: 91%

Wide variation in adoption of screening and infection control interventions for multidrug-resistant organisms: A national study

Pogorzelska¹,

Larson²

2012

American Journal of Infection Control

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Background We performed a survey of National Healthcare Safety Network hospitals in 2008 to describe adoption of screening and infection control policies aimed at multidrug-resistant organisms (MDRO) in intensive care units (ICUs) and identify predictors of their presence, monitoring, and implementation. Methods Four hundred forty-one infection control directors were surveyed using a modified Dillman technique. To explore differences in screening and infection control policies by setting characteristics, bivariate and multivariable logistic regression models were constructed. Results In total, 250 hospitals participated (57% response rate). Study ICUs (n = 413) routinely screened for methicillin-resistant Staphylococcus aureus (59%); vancomycin-resistant Enterococcus (22%); multidrug-resistant, gram-negative rods (12%); and Clostridium difficile (11%). Directors reported ICU policies to screen all admissions for any MDRO (40%), screen periodically (27%), utilize presumptive isolation/contact precautions pending a screen (31%), and cohort colonized patients (42%). Several independent predictors of the presence and implementation of different interventions including mandatory reporting and teaching status were identified. Conclusion This study found wide variation in adoption of MDRO screening and infection control interventions, which may reflect differences in published recommendations or their interpretation. Further research is needed to provide additional insight on effective strategies and how best to promote compliance.

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Methicillin-resistant Staphylococcus aureus (MRSA) in Europe: which infection control measures are taken?

Cited by 37 publications

References 18 publications

A European survey of nosocomial infection control and hospital-acquired pneumonia prevention practices

A European survey of nosocomial infection control and hospital-acquired pneumonia prevention practices

Screening and control of methicillin-resistant Staphylococcus aureus in 186 intensive care units: different situations and individual solutions

Wide variation in adoption of screening and infection control interventions for multidrug-resistant organisms: A national study

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