title: Methicillin-resistant Staphylococcus aureus in Saarland, Germany: a statewide admission prevalence screening study.
abstract: BACKGROUND
  The screening of hospital admission patients for methicillin resistant Staphylococcus aureus (MRSA) is of undisputed value in controlling and reducing the overall MRSA burden; yet, a concerted parallel universal screening intervention throughout all hospitals of an entire German Federal State has not yet been performed.
  
  
  RESULTS
  During a four-week period, all 24 acute care hospitals of the State of Saarland participated in admission prevalence screening. Overall, 436/20,027 screened patients revealed MRSA carrier status (prevalence, 2.2/100 patients) with geriatrics and intensive care departments associated with highest prevalence (7.6/100 and 6.3/100, respectively). Risk factor analysis among 17,975 admission patients yielded MRSA history (OR, 4.3; CI₉₅ 2.7-6.8), a skin condition (OR, 3.2; CI₉₅ 2.1-5.0), and/or an indwelling catheter (OR, 2.2; CI₉₅ 1.4-3.5) among the leading risks. Hierarchical risk factor ascertainment of the six risk factors associated with highest odd's ratios would require 31% of patients to be laboratory screened to allow for detection of 67% of all MRSA positive admission patients in the State.
  
  
  CONCLUSIONS
  State-wide admission prevalence screening in conjunction with risk factor ascertainment yields important information on the distribution of the MRSA burden for hospitals, and allows for data-based decisions on local or institutional MRSA screening policies considering risk factor prevalence and expected MRSA identification rates.
authors.affiliation: Institute and State Laboratory of Medical Microbiology and Hygiene, Saarland University Medical Center, Homburg, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Herrmann
authors.forename: Christine
authors.initials: C
authors.lastname: Petit
authors.forename: Alik
authors.initials: A
authors.lastname: Dawson
authors.forename: Judith
authors.initials: J
authors.lastname: Biechele
authors.forename: Alexander
authors.initials: A
authors.lastname: Halfmann
authors.forename: Lutz
authors.initials: L
authors.lastname: von Müller
authors.forename: Stefan
authors.initials: S
authors.lastname: Gräber
authors.forename: Stefan
authors.initials: S
authors.lastname: Wagenpfeil
authors.forename: Renate
authors.initials: R
authors.lastname: Klein
authors.forename: Barbara
authors.initials: B
authors.lastname: Gärtner
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006748:Hospital Departments; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus; D055815:Young Adult
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