title: Methicillin-resistant Staphylococcus aureus carriage among patients after hospital discharge.
abstract: OBJECTIVE
  At the University Medical Center Utrecht (UMCU), follow-up implies an inventory of risk factors and screening for MRSA colonization among all MRSA-positive patients for at least 6 months. If risk factors or positive cultures persist or re-emerge, longer follow-up is indicated and isolation at readmission. This study investigated how long MRSA-positive patients remained colonized after hospital discharge and which risk factors were important. Furthermore, the results of eradication therapy were evaluated.
  
  
  METHODS
  All patients who were positive for MRSA at the UMCU between January 1991 and January 2001 were analyzed regarding carriage state, presence of risk factors for prolonged carriage of Staphylococcus aureus, and eradication treatment.
  
  
  RESULTS
  A total of 135 patients were included in the study. The median follow-up time was 1.2 years. Eighteen percent of the patients were dismissed from follow-up 1 year after discharge. Only 5 patients were dismissed after 6 months. Among patients with no risk factors, eradication treatment was effective for 95% within 1 year. Among patients with persistent risk factors, treatment was effective for 89% within 2 years.
  
  
  CONCLUSIONS
  Based on these findings, eradication therapy should be prescribed for all MRSA carriers, independent of the presence of risk factors. MRSA-positive patients should be evaluated for 6 months for the presence of risk factors and MRSA carriage. Screening for risk factors is important because intermittent MRSA carriage was found in a significant number of our patients. Patients with negative MRSA cultures and without risk factors for 12 months can be safely dismissed from follow-up.
authors.affiliation: University Medical Center Utrecht, Department of Surgery, Utrecht, The Netherlands.
authors.forename: Menno R
authors.initials: MR
authors.lastname: Vriens
authors.forename: Hetty E M
authors.initials: HE
authors.lastname: Blok
authors.forename: Ada C M
authors.initials: AC
authors.lastname: Gigengack-Baars
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Mascini
authors.forename: Chris
authors.initials: C
authors.lastname: van der Werken
authors.forename: Jan
authors.initials: J
authors.lastname: Verhoef
authors.forename: Annet
authors.initials: A
authors.lastname: Troelstra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D017053:Infection Control / Q000706:statistics & numerical data; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects*