[Systematic screening for methicillin-resistant Staphylococcus aureus (MRSA) in the nasal cavities of patients hospitalized in the dermatology departments of the Saint-Louis Hospital].
OBJECTIVE
In a bid to combat methicillin-resistant Staphylococcus aureus (MRSA) more efficiently in our department, we performed a study to 1) clarify the MRSA carriage rate in patients hospitalized in the department; 2) evaluate the rate of MRSA acquisition during hospitalization; 3) describe the MRSA carrier profile; 4) study the morbidity and mortality associated with MRSA.


METHODS
We conducted a three-month prospective study in all patients hospitalized for more than 24hours in the dermatology department of the Saint-Louis Hospital. Nasal swab cultures were performed on the day of admission, once a week thereafter and on the day of discharge. Clinical and epidemiological data were individually reviewed by means of a standardized questionnaire.


RESULTS
In 310 patients, the prevalence of nasal MRSA carriage at admission was 6.5%. During hospitalization, 1.9% of our patients became colonized with MRSA. MRSA carriers were significantly older than non-carriers and had been hospitalized more frequently over the previous 12 months, principally in intensive care or in intermediate or long-term care facilities, and erosive and/or ulcerated dermatitis was more common in this population. Of the 27 patients colonized with MRSA, only three had MRSA infections, and these were successfully treated with antibiotics.


CONCLUSIONS
The observed rate of MRSA carriage was close to that seen in intensive care units (7%). While systematic screening for MRSA in patients with erosive and/or ulcerated dermatitis would allow detection of twice as many cases of MRSA than the usual screening recommendations, this would be associated with little tangible benefit and high costs, and we therefore decided not to change the usual MRSA screening politic in our dermatology department.
Gener
G
G
Service de dermatologie, université Paris-VII Denis-Diderot, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
Dupuy
A
A
Rouveau
M
M
Claisse
J-P
JP
Casin
I
I
Dubertret
L
L
Morel
P
P
Simon
F
F
Viguier
M
M
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002353:Carrier State / Q000175:diagnosis; D003428:Cross Infection / Q000517:prevention & control*; D003627:Data Interpretation, Statistical; D003880:Dermatology; D005260:Female; D006748:Hospital Departments; D006801:Humans; D008297:Male; D008403:Mass Screening; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology*; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents