Control of endemic MRSA—what is the evidence? A personal view

Marshall, Caroline; Wesselingh, Steven Lodewyk; McDonald, Malcolm; Spelman, Denis

doi:10.1016/j.jhin.2004.02.001

Cited by 65 publications

(66 citation statements)

References 176 publications

(149 reference statements)

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“…3 Effective control of MRSA in epidemic settings has been extensively demonstrated, 2,5,7,19,31,[34][35][36][37] but the feasibility of controlling endemic situations with high MRSA rates has been questioned. [35][36][37] Our study demonstrates that this objective can be reached at the scale of a large medical institution. Partial control of MRSA was achieved in Belgian hospitals in the mid-1990s 38 but was not maintained over time.…”

Section: Susceptibility Pattern In Mrsamentioning

confidence: 99%

“…50 Other measures likely played a role such as signaling procedures that helped to better identify patients with MRSA infections or colonizations 19 and feedback that stimulated the efforts. 36,51 Finally, a sustained leadership involved intensivists, bacteriologists, and infection control practitioners who championed the initiative, and a strong commitment of AP-HP administration provided an efficient incentive.…”

Section: Susceptibility Pattern In Mrsamentioning

confidence: 99%

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Curbing Methicillin-Resistant Staphylococcus aureus in 38 French Hospitals Through a 15-Year Institutional Control Program

Trystram²,

et al. 2010

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Section: Susceptibility Pattern In Mrsamentioning

confidence: 99%

Section: Susceptibility Pattern In Mrsamentioning

confidence: 99%

Curbing Methicillin-Resistant Staphylococcus aureus in 38 French Hospitals Through a 15-Year Institutional Control Program

Trystram²,

et al. 2010

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“…Methicillin-resistant S. aureus (MRSA) emerged in the 1960s and has since become a major cause of illness and death in the health care setting (2). In the 2008 National Healthcare Safety Network, MRSA represented over half of all S. aureus health care-associated infections in the United States (3).…”

mentioning

confidence: 99%

Long-Term Risk for Readmission, Methicillin-Resistant Staphylococcus aureus (MRSA) Infection, and Death among MRSA-Colonized Veterans

Joaquin¹,

Diekema

Perencevich

et al. 2013

Antimicrob Agents Chemother

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While numerous studies have assessed the outcomes of methicillin-resistant S. aureus (MRSA) colonization over the short term, little is known about longer-term outcomes after discharge. An assessment of long-term outcomes could provide information about the utility of various MRSA prevention approaches. A matched-cohort study was performed among Veterans Affairs (VA) patients screened for MRSA colonization between the years 2007 and 2009 and followed to evaluate outcomes until 2010. Cox proportional-hazard models were used to evaluate the association between MRSA colonization and long-term outcomes, such as infection-related readmission and crude mortality. A total of 404 veterans were included, 206 of whom were MRSA carriers and 198 of whom were noncarriers. There were no culture-proven MRSA infections on readmission among the noncarriers, but 13% of MRSA carriers were readmitted with culture-proven MRSA infections on readmission (P < 0.01). MRSA carriers were significantly more likely to be readmitted, to be readmitted more than once due to proven or probable MRSA infections, and to be readmitted within 90 days of discharge than noncarriers (P < 0.05). Infection-related readmission (adjusted hazard ratio [HR] ‫؍‬ 4.07; 95% confidence interval [CI], 2.16 to 7.67) and mortality (adjusted HR ‫؍‬ 2.71; 95% CI, 1.87 to 3.91) were significantly higher among MRSA carriers than among noncarriers after statistically adjusting for potential confounders. Among a cohort of VA patients, MRSA carriers are at high risk of infection-related readmission, MRSA infection, and mortality compared to noncarriers. Noncarriers are at very low risk of subsequent MRSA infection. Future studies should address whether interventions such as nasal or skin decolonization could result in improved outcomes for MRSA carriers.

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“…Diesem Eingangsscreening bei stationärer Aufnahme sollten primär Patienten mit bekanntem MRSA-Risiko gemäß Tabelle 2 unterzogen werden, um einen effektiven Einsatz der Laborkapazität zu gewährleisten. Es gibt Publikationen, in denen die Effektivität der räumlichen Isolierung in Zweifel gezogen wird [21,22]. Dazu ist anzumerken, dass die Isolierung Teil einer Multibarrierenstrategie und nur im Zusammenwirken mit allen anderen Maßnahmen gerechtfertigt ist.…”

Section: Diagnostik Bei Screeningunclassified

Infektionen durch Methicillin-resistente Staphylococcus aureus (MRSA)

Heeg

Schröppel

2009

Med Klin

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The increasing number of complicated soft-tissue or invasive infections caused by methicillin-resistant Staphylococcus aureus (MRSA) is a frequent reason for elaborate treatment regimens. Unidentified MRSA carriers may be the origin of endemic spread to other patients and medical staff. Recently, community-associated cMRSA with particular virulence factors were isolated from persons without the typical history of hospital contacts. Molecular tools for the timely detection of the mecA resistance gene for the identification of MRSA in medical test specimens have become a standard approach in MRSA-related diagnostic procedures. The actual therapy of MRSA infections requires consideration of both the appropriate spectrum of activity and the adequate pharmacological properties of a chosen antimicrobial. Preventive strategies rely on the consistent application of standard hygiene precautions, which have to be supplemented with increased barriers for the isolation of identified MRSA patients.

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Control of endemic MRSA—what is the evidence? A personal view

Cited by 65 publications

References 176 publications

Curbing Methicillin-Resistant Staphylococcus aureus in 38 French Hospitals Through a 15-Year Institutional Control Program

Curbing Methicillin-Resistant Staphylococcus aureus in 38 French Hospitals Through a 15-Year Institutional Control Program

Long-Term Risk for Readmission, Methicillin-Resistant Staphylococcus aureus (MRSA) Infection, and Death among MRSA-Colonized Veterans

Infektionen durch Methicillin-resistente Staphylococcus aureus (MRSA)

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