Systematic literature analysis and review of targeted preventive measures to limit healthcare-associated infections by meticillin-resistant Staphylococcus aureus

Author:

Köck R1,Becker K2,Cookson B3,van Gemert-Pijnen J E4,Harbarth S5,Kluytmans J6,Mielke M7,Peters G2,Skov R L8,Struelens M J9,Tacconelli E10,Witte W11,Friedrich A W12

Affiliation:

1. Institute of Hygiene, University Hospital Münster, Münster, Germany

2. Institute of Medical Microbiology, University Hospital Münster, Münster, Germany

3. Division of lnfection and lmmunity, University College London, London, United Kingdom

4. Faculty of Behavioural Sciences, University of Twente, Enschede, the Netherlands

5. Infection Control Program, University of Geneva Hospitals and Medical School, Geneva, Switzerland

6. Department of Medical Microbiology and Infection Control, VU University Medical Centre, Amsterdam and Amphia Hospital Molengracht, Breda, the Netherlands

7. Robert Koch Institute, Department for Infectious Diseases, Berlin, Germany

8. Department for Microbiology and Infection Control for Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark

9. European Centre for Disease Prevention and Control, Stockholm, Sweden

10. Division of Infectious Diseases, Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany

11. Robert Koch Institute, Reference Centre for Staphylococci, Wernigerode, Germany

12. Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

Abstract

Meticillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections in Europe. Many examples have demonstrated that the spread of MRSA within healthcare settings can be reduced by targeted infection control measures. The aim of this systematic literature analysis and review was to summarise the evidence for the use of bacterial cultures for active surveillance the benefit of rapid screening tests, as well as the use of decolonisation therapies and different types of isolation measures. We included 83 studies published between 2000 and 2012. Although the studies reported good evidence supporting the role of active surveillance followed by decolonisation therapy, the effectiveness of single-room isolation was mostly shown in non-controlled studies, which should inspire further research regarding this issue. Overall, this review highlighted that when planning the implementation of preventive interventions, there is a need to consider the prevalence of MRSA, the incidence of infections, the competing effect of standard control measures (e.g. hand hygiene) and the likelihood of transmission in the respective settings of implementation.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

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