Prospective Study of Methicillin-Resistant Staphylococcus aureus Colonization in an Internal Medicine Ward: Population, Risk Factors and Implications
DOI:
https://doi.org/10.24950/rspmi/29/2017Keywords:
Cross Infection, Hospital Departments, Internal Medicine, Methicillin-Resistant Staphylococcus aureus, Staphylococcal InfectionsAbstract
Introduction: The infection by Staphylococcus aureus methicillin-resistant (MRSA) is one of the most important healthcare-
associated infections. In 2014 there was a rule from the National Directorate of Health addressed to this problem.
This study aims to quantify the patients with indication to search for MRSA colonization, examine the criteria, implications
and possible strategies.
Materials and Methods: Prospective data about patients admitted to an Internal Medicine Department in five non-consecutive
weeks.
Results: The sample includes 224 patients, mostly female, with a mean age of 76 years old. The majority (60.3%) presented indication for screening, which was conducted in 39.3% of the patients; 28.3% were positive. The most common criteria presented were prior antibiotic therapy (37.1%), recent hospitalization (32.1%) and transfer from a hospital
institution (16.1%).
Discussion: The age factor seems to influence the probability of indication for screening. Most patients showed indication to search for MRSA colonization (60.3%), which means a huge need for practices change. The high level of antibiotic therapy assumes great relevance in this sample (37.1%). In most of the patients, the screening was not done and it is necessary to sensitize the medical and nursing team.
Conclusion: It is important to require good practices from health professionals for the implementation of new rules and ensure operating conditions in the services in order they can be applied. It is crucial that the strategies are not implemented
alone. The patient must fulfill his part by not taking unjustified antibiotics.
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References
Gould IM, Abhijit MB. New antibiotic agents in the pipeline and how they can help overcome microbial resistance. Virulence. 2013;185–91.
Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. Pharm Therap. 2015;40.4:277-83.
World Health Organization. Antimicrobial resistance: global report on surveillance. Geneve: WHO; 2014.
Direção Geral da Saúde. Portugal – Prevenção e controlo de infeções e de resistência aos antimicrobianos em números. Lisboa: DGS; 2015.
Owens RC, Rice L. Hospital-based strategies for combating resistance. Clin Infect Dis. 2006;42(Suppl 4):173–81.
Revelas A. Healthcare–associated infections: A public health problem. Niger Med J. 2012;53:59-64.
European Centre for Disease Prevention and Control. Annual epidemiological report 2014. Antimicrobial resistance and healthcare associated infections. Solna: ECDPC; 2015.
Stamm A, Long M, Belcher B. Higher overall nosocomial infection rate because of increased attack rate of methicillinresistant Staphylococcus aureus. Am J Infect Control. 1993;21:70–4.
Datta R, Huang S. Risk of infection and death due to methicillin-resistant Staphylococcus aureus in long-term carriers. Clin Infect Dis.
;47:176–81.
Huang S, Platt R. Risk of methicillin-resistant Staphylococcus aureus infection after previous infection or colonization. Clin Infect Dis.
;36:281–5.
European Centre for Disease Prevention and Control. Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals. Solna: ECDPC; 2013.
Cox RA, Conquest C. Strategies for the management of healthcare staff colonised with epidemic methicillin- resistant Staphylococcus aureus. J Hosp Infect. 1997;35:117–27.
Thelwall S, Nsonwu O, Wasti S, Elmi M, Gerver S, Davies J, et al. Annual Epidemiological Commentary Mandatory MRSA, MSSA and E. coli bacteraemia and C. difficile infection data 2015/16 [Internet]. [accessed10-11-2016] Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/535635/AEC_final.pdf
Chief Medical Officer. Winning Ways: Working together to reduce Healthcare Associated Infection in England. [Internet]. 2003. [accessed 10-11-2016] Available from: http://antibiotic-action.com/wp-content/ uploads/2011/07/DH-Winning-ways-working-together-to-reduce-HCAI.-2003.pdf
Carlet J, Astagneau P, Brun-Buisson C, Coignard B, Tran B, Desenclos JC. French national program for prevention of healthcare-associated infections and antimicrobial resistance, 1992–2008: positive trends, but perseverance needed. Infect Control Hosp Epidemiol. 2009;30:737–45.
Jans B, Glupczynski Y, Goossens H, Denis O. Surveillance van antibioticaresistente bacteriën in Belgische ziekenhuizen: Jaarrapport 2014 [Internet]. [accessed 10-11-2016] Available from: http://www.nsih.be/download/MRSA/MRSA_ESBL_CPE_Y2014/RAPPORT_AMR_Y2014_NL.pdf
GDEPIH - GOSPIZ. Guidelines for the control and prevention of methicillin- resistant Staphylococcus aureus transmission in Belgian hospitals. [Internet]. [accessed 10-11-2016] Available from: http://www.health.belgium.be/sites/default/files/uploads/fields/fpshealth_theme_file/4448393/Guidelines for the control and prevention of methicillin-resistant Staphylococcus Aureus transmission in Belgian hospitals (June 2005) (SHC7725).pdf
Köck R, Becker K, Cookson B, van Gemert-Pijnen JE, Harbarth S, Kluytmans J, et al. Methicillin-resistant Staphylococcus aureus (MRSA): burden of disease and control challenges in Europe. Euro Surveill. 2010;15):19688.
Direção Geral da Saúde. Prevenção e controlo de colonização e infeção por Staphylococcus aureus resistente à meticilina (MRSA) nos hospitais e unidades de internamento de cuidados continuados integrados 018/2014 (actualizada 27-04-2015). Lisboa: DGS; 2015.
Direção Geral da Saúde. Recomendações para as precauções de isolamento. Precauções básicas e dependentes das vias de transmissão. [Internet]. 2007. [accessed 17-12-2016] Available from: http://www.dgs.pt/ms/3/default.aspx?pl=&id=5514&acess=0&codigono=
AAAAAAAAAAAAAAAA
European Centre for Disease Prevention and Control. Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals.Solna: ECDPC; 2013.
Fitzpatrick F, Murphy OM, Brady A, Prout S, Fenelon LE. A purpose built MRSA cohort unit. J Hosp Infect. 2000;46:271–9.
Morgan DJ, Murthy R, Munoz-price LS, Barnden M, Camins BC, Johnston BL, et al.Reconsidering contact precautions for endemic methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus. Infect Control Hosp Epidemiol. 2015;36:1163–72.
Baraboutis AI, Tsagalou EP, Papakonstantinou I, Marangos MN, Gogos C, Skoutelis AT, et al. Length of exposure to the hospital environment is more important than antibiotic exposure in healthcare associated infections by methicillin-resistant Staphylococcus aureus : a comparative study. Braz J Infect Dis. 2011;15:426–35.
Tacconelli E, Angelis G De, Cataldo MA, Pozzi E, Cauda R. Does antibiotic exposure increase the risk of methicillin-resistant Staphylococcus aureus (MRSA) isolation ? A systematic review and meta-analysis. J Antimicrob Chemother. 2008;61:26–38.
Bradley SF. Eradication or decolonization of methicillin-resistant Staphylococcus aureus carriage: what are we doing and why are we doing it? Clin Infect Dis. 2007;44:186–9.
European Comission. Special Eurobarometer 407 - Antimicrobial resistance. Brussels: EC; 2013.
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