Systematic literature analysis and review of targeted preventive measures to limit healthcare-associated infections by meticillin-resistant Staphylococcus aureus

Abstract

Meticillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections in Europe. Many examples have demonstrated that the spread of MRSA within healthcare settings can be reduced by targeted infection control measures. The aim of this systematic literature analysis and review was to summarise the evidence for the use of bacterial cultures for active surveillance the benefit of rapid screening tests, as well as the use of decolonisation therapies and different types of isolation measures. We included 83 studies published between 2000 and 2012. Although the studies reported good evidence supporting the role of active surveillance followed by decolonisation therapy, the effectiveness of single-room isolation was mostly shown in non-controlled studies, which should inspire further research regarding this issue. Overall, this review highlighted that when planning the implementation of preventive interventions, there is a need to consider the prevalence of MRSA, the incidence of infections, the competing effect of standard control measures (e.g. hand hygiene) and the likelihood of transmission in the respective settings of implementation

Infection control: Evidence-based common sense

“…Once again, there is little substantial evidence to support this type of segregation from the infection prevention point of view, while there is evidence to show that isolated patients tend to suffer from loneliness and reduced clinical attention [15,22,24]. Indeed, understaffed wards cannot provide the nursing care required for isolated patients since they are not continually observed.…”

“…Patient screening is not without critique; although heavily defended if the evidence base is challenged [18e21]. The decolonisation programmes offered to carrier patients have also been criticised; for lack of clinical benefit and concern over increasing resistance or tolerance to the agents used in the topical clearance regimens [15,18,22]. Indeed, the current vogue for bathing everyone with antiseptics, notably chlorhexidine, has ignited much discussion with, as yet, no clear decision to help policy makers [23].…”

A mobil kommunikációs eszközök szerepe a fertőzések átvitelében. Szisztematikus irodalomelemzés

“…A problémát az okozza, hogy a vizsgálatunkban szereplő tanulmányok eredményei alapján a koagulázne-gatív Staphylococcusoknak a 17,1-87,9%-a, a Staphylococcus aureusoknak pedig a 10-95,3%-a methicillinrezisztenciával rendelkezett [9,11,14,16,18,19,21,22,23,24,25,26,27,29,32,34,35,36]. Ezek a multirezisztens kórokozók növelik a morbiditást, a halálo-zást és a kórházi költségeket, illetve jelentősen beszűkítik a terápiás lehetőségeket [38,39].…”

“…Az oktatási programnak tartalmaznia kell a kézhigiéné elmé-leti ismereteit, a kézhigiéné indikációit (a beteg érintése előtt és után, aszeptikus beavatkozások előtt, testvála-dékkal történt érintkezés után, a beteg környezetével történő érintkezést követően), illetve a kézhigiénés tevé-kenység gyakorlatban történő végrehajtásának szabályait és kivitelezését [39,40].…”

Authors’ reply: Systematic literature analysis and review of targeted preventive measures to limit healthcare-associated infections by meticillin-resistant Staphylococcus aureus

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To the editor:We thank Prof. Verbrugh for the letter in regard to our article Systematic literature analysis and review of targeted preventive measures to limit healthcare-associated infections by meticillin-resistant Staphylococcus aureus (MRSA) [1]. As mentioned by Prof. Verbrugh, the article describing the United States Veteran Affairs (VA) initiative to combat MRSA [2] was discussed in our review, but not included in the body of the text and not reviewed in detail.

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