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Epidemiology of MRSA colonisation in a university hospital and a cardiosurgical hospital in Hessen, Germany

Abstract number: 1733_1436

Knaust A., Madlener K., Tschernych N., Barekzai J., Eikmann T., Herr C.

Objectives: Infections caused by methicillin resistant Staphylococcus aureus (MRSA) are a major health problem in German hospitals, causing increased duration of hospital stay and incidence of mortality. In 2004 the Paul-Ehrlich Institute published a rate of 22.6 percent methicillin resistant isolates amongst all S. aureus isolates sent in by reference laboratories. Since rates of methicillin resistance have constantly increased during the last decades strategies to prevent a further spread of MRSA are urgently needed. Screening of incoming patients became more and more evident to be an effective method to decrease rates of colonisation and infection with MRSA in hospital patients. In previous studies various designs were used for MRSA screening and each strategy needs careful evaluation for each hospital or healthcare facility.

Methods: In the current study based in a university hospital and a cardiosurgical hospital, different strategies were used to screen incoming patients for colonisation or infection with MRSA: (i) patients who belong to risk groups (history or MRSA, wounds, haemodialysis, submission from healthcare facilities); (ii) patients who were admitted to selected departments or wards (intensive care units); (iii) all patients were screened upon admission. Microbiological diagnostics were performed either by bacterial cultures or by a real time PCR based method.

Results and Conclusion: The total prevalence of MRSA colonisation and/or infection was about 3 percent during the initial four month period comprising more than 1000 screening samples. Most of the classical risk factors showed only weak correlation to an enhanced risk of MRSA colonisation. Screening of risk groups will miss many asymptomatic MRSA carriers as could be shown when complete screening of all admissions was performed. A fast microbiological verification is of great advantage for patient management on the wards to reduce preventive isolation measures, i.e. single rooms. Each hospital needs to evaluate its individual patient population to establish an effective and save screening strategy to prevent MRSA transfer and infection.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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