title: A survey of methicillin-resistant Staphylococcus aureus control strategies in Italy.
abstract: OBJECTIVE
  Data regarding the implementation of state-of-the-art methicillin-resistant Staphylococcus aureus (MRSA) control procedures in Italy are lacking. There is a need to evaluate compliance with MRSA recommendations (CR) in Italian hospitals.
  
  
  METHODS
  A 67-question closed-answer survey was sent to all Italian hospitals, in order to analyze and evaluate program consistency with CR [hand hygiene (HH), contact precautions, screening of high-risk patients, decolonization, feedback on surveillance data, and antimicrobial guidelines and education programs].
  
  
  RESULTS
  205 hospitals, which account for 42 % of national admissions, returned questionnaires. 131 hospitals (64 %) did not have written MRSA control guidelines. Hospitals reported the following levels of compliance with CR: (1) HH: 67 hospitals (33 %); (2) contact precautions: 33 (16 %); (3) MRSA screening: 66 (32 %); (4) MRSA decolonization: 42 (20 %); (5) surveillance data feedback: 87 (43 %); and (6) antimicrobial guidelines and education programs: 41 (20 %). One hospital (0.5 % of responses) had implemented all recommendations and 28 hospitals (14 %) had implemented four or five recommendations. 31 % of hospitals surveyed had implemented none. Multivariate analysis showed that the only factor identified as being associated with the implementation of MRSA control recommendations was the number of meetings/year of the infection control team (ICT) (p = 0.004).
  
  
  CONCLUSIONS
  Written MRSA control guidelines are available in only one-third of Italian facilities. An organized system, with ≥4 interventions, has been implemented in just 1 out of 7 hospitals. HH programs and ICT activity are related to better MRSA control. In Italy, there is significant opportunity for improvement in MRSA control.
authors.affiliation: Divisione di Malattie Infettive e Tropicali, Istituti Ospitalieri di Cremona, Largo Priori, 1, 26100, Cremona, Italy. a.pan@ospedale.cremona.it
authors.forename: A
authors.initials: A
authors.lastname: Pan
authors.forename: E
authors.initials: E
authors.lastname: Bombana
authors.forename: G
authors.initials: G
authors.lastname: Tura
authors.forename: C
authors.initials: C
authors.lastname: Curti
authors.forename: S
authors.initials: S
authors.lastname: Lorenzotti
authors.forename: P
authors.initials: P
authors.lastname: Mondello
authors.forename: A
authors.initials: A
authors.lastname: Patroni
authors.forename: E
authors.initials: E
authors.lastname: Tacconelli
authors.forename: V
authors.initials: V
authors.lastname: Rigobello
authors.forename: L
authors.initials: L
authors.lastname: Signorini
authors.forename: M
authors.initials: M
authors.lastname: Vizio
authors.forename: A
authors.initials: A
authors.lastname: Goglio
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006302:Health Services Research; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007558:Italy / Q000453:epidemiology; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires
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