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Are There Regional Variations in the Diagnosis, Surveillance, and Control of Methicillin-Resistant Staphylococcus aureus?

Published online by Cambridge University Press:  02 January 2015

Hervé M. Richet*
Affiliation:
Investigation and Prevention Branch, Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Mohamed Benbachir
Affiliation:
Laboratoire de Microbiologie, Centre Hospitalier Ibn Rochd, Casablanca, Maroc
Derek F. J. Brown
Affiliation:
Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, United Kingdom
Helen Giamarellou
Affiliation:
4th Department of Internal Medicine, Sismanoglio General Hospital, Maroussi Attikis, Greece
Ian Gould
Affiliation:
Clinical Microbiology, Aberdeen Royal Hospitals, NHS Trust, Aberdeen, Scotland, United Kingdom
Marija Gubina
Affiliation:
Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
Piotr Heczko
Affiliation:
Microbiology Department, Jagiellonian University Medical School, Krakow, Poland
Smilja Kalenic
Affiliation:
Department of Clinical and Molecular Microbiology, Zagreb University School of Medicine, Zagreb, Croatia
Marina Pana
Affiliation:
Streptococcus National Reference Center, Institutul Cantacuzino, Bucarest, Romania
Didier Pittet
Affiliation:
Unité de Prévention et de Contrôle de l'Infection, Hôpitaux Universitaires de Genève, Genève, Suisse
Saida Ben Redjeb
Affiliation:
Laboratoire de Bactériologie, Hôpital Charles Nicolle, Tunis, Tunisie
Jiri Schindler
Affiliation:
Department of Medical Microbiology, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
Carlos Starling
Affiliation:
Fetido Rocho, Vera Cruz and São Francisco Hospitals, Belo Horizonte, Brazil
Marc J. Struelens
Affiliation:
Department of Microbiology, Université Libre de Bruxelles, Hôpital Erasme, Bruxelles, Belgique
Wolfgang Witte
Affiliation:
Robert-Koch Institut, Bunderinstitüt für Infektionskrankheiten, Wernigerode, Germany
William R. Jarvis
Affiliation:
Investigation and Prevention Branch, Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, Institut de Biologie des Hôpitaux de Nantes, 9, quai Moncousu, BP 1005, 44093 Nantes cedex 01, France

Abstract

Objective:

To assess the way healthcare facilities (HCFs) diagnose, survey, and control methicillin-resistant Staphylococcus aureus (MRSA).

Design:

Questionnaire.

Setting:

Ninety HCFs in 30 countries.

Results:

Evaluation of susceptibility testing methods showed that 8 laboratories (9%) used oxacillin disks with antimicrobial content different from the one recommended, 12 (13%) did not determine MRSA susceptibility to vancomycin, and 4 (4.5%) reported instances of isolation of vancomycin-resistant S. aureus but neither confirmed this resistance nor alerted public health authorities. A MRSA control program was reported by 55 (61.1%) of the HCFs. The following isolation precautions were routinely used: hospitalization in a private room (34.4%), wearing of gloves (62.2%), wearing of gowns (44.4%), hand washing by healthcare workers (53.3%), use of an isolation sign on the patient's door (43%), or all four. When the characteristics of HCFs with low incidence rates (< 0.4 per 1,000 patient-days) were compared with those of HCFs with high incidence rates (P = 0.4 per 1,000 patient-days), having a higher mean number of beds per infection control nurse was the only factor significantly associated with HCFs with high incidence rates (834 vs 318 beds; P = .02).

Conclusion:

Our results emphasize the urgent need to strengthen the microbiologic and epidemiologic capacities of HCFs worldwide to prevent MRSA transmission and to prepare them to address the possible emergence of vancomycin-resistant S. aureus.

Type
Orginal Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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