Strategy to Control Methicillin-Resistant Staphylococcus Aureus: The 5 Year Experience of a Hospital

• Autor(a) principal: Peres, David
• Data de Publicação: 2014
• Outros Autores: Neves, Isabel, Vieira, Fernanda, Devesa, Ilda
• Tipo de documento: Artigo
• Idioma: por; eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4736

Introduction: Methicillin-resistant Staphylococcus aureus remains one of the principal resistant pathogens causing serious healthcareassociated infections. The objective of this study was to control and monitor methicillin-resistant Staphylococcus aureus cases using multimodal strategy in a Portuguese hospital.Material and Methods: Multistep procedure involving isolation measures and active surveillance cultures in a selected population (patients from other hospitals and nursing homes; history of hospitalization/ methicillin-resistant Staphylococcus aureus; intensive and intermediate care patients and, in other inpatient services, direct contacts of newly detected methicillin-resistant Staphylococcus aureus patients and, since 2012, patients doing hemodialysis). Other parallel activities: (a) review of isolation and standard precautions policy, (b) reinforcement of alcohol-based handrubs at point of patient care, (c) information sessions to health professionals, (d) targeted information flyer for health professionals, (e) information leaflet for patients/ visitors; (f) procedure monitoring by audit (g) patient decolonization in intensive and intermediate care units, with follow-up screenings.Results: Between 2007 and 2012, methicillin-resistant Staphylococcus aureus surveillance detected a decrease in proportion from 66% to 57% and, in density of incidence, from 1.80 to 0.68 cases per thousand days of hospitalization (p < 0.001; RR 0.38; CI95%: 0.29-0.49).Discussion/Conclusion: According to published European data, using blood and cerebrospinal fluid isolates only, Portugal was the country with the highest level of methicillin-resistant Staphylococcus aureus in 2011. Using this inclusion criteria, our hospital reveled a proportion of methicillin-resistant Staphylococcus aureus below its national level (34% versus 55%) in 2011. Fighting methicillinresistant Staphylococcus aureus using a multimodal strategy is being effective in a high endemic level hospital, but perseverance is needed through continuous surveillance of cases, feed-back to professionals and procedure audits.