National survey of methicillin-resistant Staphylococcus aureus in Belgian hospitals: detection methods, prevalence trends and infection control measures. The Groupement pour le Dépistage, l'Etude et la Prévention des Infections Hospitalières.
A questionnaire survey of Belgian acute care hospitals was conducted to determine the methods used for detection of methicillin-resistant Staphylococcus aureus (MRSA), to estimate the prevalence of this organism during the period 1989-1991 and to describe the infection control measures used locally for limiting its spread. Questionnaires were returned by 144 acute care hospitals, with a coverage of 41 to 72% of hospitals by province. Methods used for detection of MRSA included disk diffusion (91%), microdilution panels (8%) and oxacillin agar screen (9%). Only 34% of laboratories performed disk diffusion testing under optimal conditions for detection of heterogenous resistance. Among 36 hospitals reporting complete susceptibility data of Staphylococcus aureus isolates tested during the study period (n = 24,153), a mean MRSA prevalence of 14% was found (range: 0-70%). The median prevalence increased from 9.5% in 1989 to 13.7% in 1991 and showed a significant linear increase during this period in 30% of these hospitals (p < 0.01). Precautions used for controlling spread of MRSA included hand decontamination using either soap and water or antimicrobial preparations (68% of hospitals), room decontamination (62%), patient isolation (55%) and various barrier precautions (24-49%). Carrier screening was performed in 37% of hospitals, but antibiotic decolonization was attempted in only 24%. This survey identified areas for improvement in MRSA detection methods and underscored the need for multicentric surveillance of MRSA prevalence and a reappraisal of MRSA control strategies in Belgian hospitals.
Struelens
M J
MJ
Hospital Epidemiology and Infection Control Unit, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
Mertens
R
R
D001431:Bacteriological Techniques; D001530:Belgium / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D017053:Infection Control / Q000379:methods; D008403:Mass Screening; D016106:Methicillin Resistance; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000302:isolation & purification*