title: The burden of MRSA in four German university hospitals.
abstract: In the last few years, a dramatic increase of Methicillin-resistant Staphylococcus aureus (MRSA) detection in German hospitals can be recognized. Under this enormous pressure it is very important for infection control teams to assess the epidemiologic situation correctly. Therefore, a prospective multicenter hospital-based surveillance of MRSA cases was executed in four university hospitals with 1017-1333 beds in Germany. Routine surveillance data were recorded of all patients with MRSA isolates from clinical samples or screening cultures. Patients had been colonized or infected with MRSA during their hospital stay. In 2002 between 183 and 291 MRSA cases were treated in the respective hospitals (between 0.53 and 0.96 MRSA cases per 1000 patient days). Of these, 44.4% were MRSA infections. The most frequent type of MRSA infections were wound infections (56.9%) followed by pneumonia (21.0%) and bloodstream infections (15.1%). Of the infected patients 51.5% were already infected at admission. The median duration of isolation of MRSA patients in private rooms was between 11 and 16 days. Altogether 21,665 isolation days were observed in four hospitals; this means 1.52% of all patient days. On average, 9.0% of roommates were identified as MRSA carriers. Due to the high percentage of imported cases, the four university hospitals introduced a general screening for MRSA at admission in all ICUs and some further departments as well as an automatic alert system for readmitted patient with MRSA during their last hospital stay.
authors.affiliation: Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Carl-Neuberg-Street 1, 30625 Hannover, Germany. chaberny.iris@mh-hannover.de
authors.forename: Iris F
authors.initials: IF
authors.lastname: Chaberny
authors.forename: Stefan
authors.initials: S
authors.lastname: Ziesing
authors.forename: Frauke
authors.initials: F
authors.lastname: Mattner
authors.forename: Sina
authors.initials: S
authors.lastname: Bärwolff
authors.forename: Christian
authors.initials: C
authors.lastname: Brandt
authors.forename: Tim
authors.initials: T
authors.lastname: Eckmanns
authors.forename: Henning
authors.initials: H
authors.lastname: Rüden
authors.forename: Dorit
authors.initials: D
authors.lastname: Sohr
authors.forename: Klaus
authors.initials: K
authors.lastname: Weist
authors.forename: Petra
authors.initials: P
authors.lastname: Gastmeier
mesh_terms: D002353:Carrier State; D003428:Cross Infection / Q000453:epidemiology*; D005858:Germany; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D016106:Methicillin Resistance; D010356:Patient Isolation; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000472:pathogenicity; D013530:Surgical Wound Infection