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 name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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