title: Are there regional variations in the diagnosis, surveillance, and control of methicillin-resistant Staphylococcus aureus?
abstract: 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.
authors.affiliation: Investigation and Prevention Branch, Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Hervé M
authors.initials: HM
authors.lastname: Richet
authors.forename: Mohamed
authors.initials: M
authors.lastname: Benbachir
authors.forename: Derek E J
authors.initials: DE
authors.lastname: Brown
authors.forename: Helen
authors.initials: H
authors.lastname: Giamarellou
authors.forename: Ian
authors.initials: I
authors.lastname: Gould
authors.forename: Marija
authors.initials: M
authors.lastname: Gubina
authors.forename: Piotr
authors.initials: P
authors.lastname: Heczko
authors.forename: Smilja
authors.initials: S
authors.lastname: Kalenic
authors.forename: Marina
authors.initials: M
authors.lastname: Pana
authors.forename: Didier
authors.initials: D
authors.lastname: Pittet
authors.forename: Saida Ben
authors.initials: SB
authors.lastname: Redjeb
authors.forename: Jiri
authors.initials: J
authors.lastname: Schindler
authors.forename: Carlos
authors.initials: C
authors.lastname: Starling
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Struelens
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Witte
authors.forename: William R
authors.initials: WR
authors.lastname: Jarvis
mesh_terms: 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