Are there regional variations in the diagnosis, surveillance, and control of methicillin-resistant Staphylococcus aureus?
OBJECTIVE
To assess the way healthcare facilities (HCFs) diagnose, survey, and control methicillin-resistant Staphylococcus aureus (MRSA).


METHODS
Questionnaire.


METHODS
Ninety HCFs in 30 countries.


RESULTS
Evaluation of susceptibility testing methods showed that 8 laboratories (9%) used oxacillin disks with antimicrobial content different from the one recommended, 12 (13%) did not determine MRSA susceptibility to vancomycin, and 4 (4.5%) reported instances of isolation of vancomycin-resistant S. aureus but neither confirmed this resistance nor alerted public health authorities. A MRSA control program was reported by 55 (61.1%) of the HCFs. The following isolation precautions were routinely used: hospitalization in a private room (34.4%), wearing of gloves (62.2%), wearing of gowns (44.4%), hand washing by healthcare workers (53.3%), use of an isolation sign on the patient's door (43%), or all four. When the characteristics of HCFs with low incidence rates (< 0.4 per 1,000 patient-days) were compared with those of HCFs with high incidence rates (> or = 0.4 per 1,000 patient-days), having a higher mean number of beds per infection control nurse was the only factor significantly associated with HCFs with high incidence rates (834 vs 318 beds; P = .02).


CONCLUSIONS
Our results emphasize the urgent need to strengthen the microbiologic and epidemiologic capacities of HCFs worldwide to prevent MRSA transmission and to prepare them to address the possible emergence of vancomycin-resistant S. aureus.
Richet
Hervé M
HM
Investigation and Prevention Branch, Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Benbachir
Mohamed
M
Brown
Derek E J
DE
Giamarellou
Helen
H
Gould
Ian
I
Gubina
Marija
M
Heczko
Piotr
P
Kalenic
Smilja
S
Pana
Marina
M
Pittet
Didier
D
Redjeb
Saida Ben
SB
Schindler
Jiri
J
Starling
Carlos
C
Struelens
Marc J
MJ
Witte
Wolfgang
W
Jarvis
William R
WR
D003428:Cross Infection / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D014943:Global Health; D006779:Hospitals, Public; D006784:Hospitals, Teaching; D006801:Humans; D017053:Infection Control / Q000379:methods*; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D018571:Sentinel Surveillance; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D020713:Vancomycin Resistance