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Screening practices for detection of MRSA-carriers in Belgian acute care hospitals and nursing homes, 2006

Abstract number: P1762

Jans B., Suetens C., Struelens M.

In Belgium, national guidelines for the prevention and control of MRSA are available since 1993 (updated: 2003) for hospitals and since 2005 for nursing homes (NH). In 2006, a nation-wide survey measured the implementation of these guidelines in both types of facilities.

Aims and methodology: All acute care hospitals (n = 201) and high care NHs (n = 986) in Belgium received a care type specific questionnaire, investigating the implemented measures for MRSA prevention and control. Several topics were examined: antibiotic policy, hand hygiene, isolation, additional precautions and screening and decontamination of reservoirs. This abstract reports the results of the implemented screening practices.

Results: A total of 131 hospitals (65%) and 484 NHs (49%) completed the questionnaire.

In hospitals, 95% performed "target" screening, 2% screened all patients and 4% never screened. Target screening was done after transfer from ICU (88%) and from geriatric (52%), surgical (23%) or medical wards (16%). Target screening at hospital admission was also performed for patients coming from NHs (99%), from another hospital (79%) or from a foreign country (26%). All respondents carried out nasal screening: 4% only nasal, 87% nasal combined with other sites. The combined screening of nose, throat and at least one skin site (axilla, groin or perineum) was performed by 42% of the hospitals. Rectal screening was done by 7%. Screening of the nursing staff was only carried out in epidemic situations (41%) or in specific situations: known carriers, personnel at risk, etc (13%).

Among NHs, 15% never screened residents. Screening at readmission after hospitalisation was performed by 47% of the NHs when no transfer document was available. When the transferring hospital mentioned that MRSA was isolated during hospitalisation, 66% of the NHs always screened and an additional 10% only if the resident was not decontaminated. Intermediate MRSA screening based on a combination of risk factors (3 of 4: high care dependency, presence of wound/catheter, use of antibiotics in previous month and known MRSA carriage) was done by 52%. At least 85% of the NH did nasal screening and 42% always sampled the classic 'nose-throat-skin".

Conclusion: Hospitals have a longer experience with screening practices and are more 'target' minded. In NHs, standardisation of screening practices is required. The use of transfer documents between hospitals and NHs should be optimised.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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