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Methicillin-Resistant Staphylococcus aureus Epidemiology and Control in Belgian Hospitals, 1991 to 1995

Published online by Cambridge University Press:  02 January 2015

Marc J. Struelens ,
Olivier Ronveaux ,
Béatrice Jans ,
Raf Mertens  and
Groupement pour le Dépistage, l'Etude et la Prévention des Infections Hospitalières
Marc J. Struelens*
Affiliation:
Hospital Epidemiology and Infection Control Unit, Department of Microbiology, Institute of Hygiene and Epidemiology, Brussels, Belgium
Olivier Ronveaux
Affiliation:
Hôpital Erasme and Infectious Diseases Epidemiology Unit, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium, and from the Epidemiology Unit, Institute of Hygiene and Epidemiology, Brussels, Belgium
Béatrice Jans
Affiliation:
Hôpital Erasme and Infectious Diseases Epidemiology Unit, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium, and from the Epidemiology Unit, Institute of Hygiene and Epidemiology, Brussels, Belgium
Raf Mertens
Affiliation:
Hôpital Erasme and Infectious Diseases Epidemiology Unit, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium, and from the Epidemiology Unit, Institute of Hygiene and Epidemiology, Brussels, Belgium
*
Microbiology Department, Hôpital Erasme, 808 route de Lennik, 1070 Brussels, Belgium
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Abstract

Objectives: To describe the Belgian methicillin-resis-tant Staphylococcus aureus (MRSA) surveillance network, the evolution of methods used in Belgian hospitals for MRSA detection and control, and MRSA incidence from 1994 to1995.

Design, Setting, and Participants: Questionnaire surveys; infection control physicians from acute-care hospitals in Belgium.

Intervention: Publication of national guidelines for MRSA control in 1993.

Results: The participation rate in surveys ranged from 42% to 57% of hospitals. In 1995, 88% of participants detected MRSA strains by disk diffusion tests, with little improvement in standardization since 1991. More centers employed the oxacillin agar screen method (27%), automated systems (29%), or a combination of methods (29%) than in 1991 (P<.005). Between 1991 and 1995, the proportion of hospitals reporting MRSA control measures increased from 68% to 95% (P<.01). Practices that were used increasingly included patient placement in private room (from 50% to 93%, P<.01) and hand decontamination with antiseptic (from 43% to 87%, P<.01). The proportion of centers that reported screening MRSA carriers and treating them topically increased two- and threefold, respectively (P<.05). Surveillance data from 1994 to 1995 showed that MRSA represented a mean of 21.3% of S aureus clinical isolates (range, 1.6% to 62.4%). The median incidence of nosocomial MRSA acquisition was 2.8 per 1,000 admissions, with a wide range (0 to 13.7 per 1,000 admissions) across hospitals of all sizes. The median incidence decreased over the first three semesters of surveillance in hospitals with continuous participation.

Conclusion: MRSA detection and control measures have improved in Belgian hospitals after publication of national guidelines. However, MRSA incidence rates show the persistence of nosocomial transmission, with large variations between centers. The national MRSA surveillance network should indicate whether control efforts eventually will curb the problem.

Type
From the Fourth International Conference on the Prevention of Infection
Information
Infection Control & Hospital Epidemiology , Volume 17 , Issue 8 , August 1996 , pp. 503 - 508
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1996

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