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Successful Control of Widespread Methicillin-Resistant Staphylococcus aureus Colonization and Infection in a Large Teaching Hospital in The Netherlands

Published online by Cambridge University Press:  02 January 2015

M. J. C. A. van Trijp ,
D. C. Melles ,
W. D. H. Hendriks ,
G. A. Parlevliet ,
M. Gommans  and
A. Ott
M. J. C. A. van Trijp*
Affiliation:
Laboratory for Medical Microbiology, Medical Center Rijnmond-Zuid, Rotterdam Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, University Medical Center, Rotterdam
D. C. Melles
Affiliation:
Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, University Medical Center, Rotterdam
W. D. H. Hendriks
Affiliation:
Laboratory for Medical Microbiology, Medical Center Rijnmond-Zuid, Rotterdam
G. A. Parlevliet
Affiliation:
Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, University Medical Center, Rotterdam
M. Gommans
Affiliation:
Laboratory for Medical Microbiology, Medical Center Rijnmond-Zuid, Rotterdam
A. Ott
Affiliation:
Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, University Medical Center, Rotterdam Laboratory for Infectious Diseases, Groningen, The Netherlands
*
Medical Center Rijnmond-Zuid, Laboratory of Medical Microbiology, Olympiaweg 350, 3078 HT Rotterdam, The Netherlands (m.vantrijp@erasmusmc.nl)
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Abstract

Objective.

The low prevalence of infection and colonization with methicillin-resistant Staphylococcus aureus (MRSA) in The Netherlands is ascribed to a national “search-and-destroy” policy. We describe the measures that were implemented to control widespread MRSA colonization and infection in a Dutch hospital.

Design.

Descriptive intervention study.

Setting.

Teaching medical center with a capacity of 679 beds, including 16 intensive care beds.

Interventions.

MRSA colonization and infection were identified using conventional culture with a selective broth. Isolates were typed using pulsed-field gel electrophoresis. Measures to control the epidemic included screening of contacts (patients and hospital staff), screening of patients at readmission or discharge, strict isolation of MRSA-positive patients, decolonization of colonized staff and patients, the development of an electronic signal identifying MRSA-positive patients, and the development of a culture information-system for hospital personnel.

Results.

Awareness of uncontrolled dissemination of MRSA began in November 2001. Because the clone involved had a low minimum inhibitory concentration for oxacillin, at first it was not recognized as MRSA. In February 2002, when major screening efforts started, it appeared that MRSA had spread all over the hospital and that many staff members were colonized. By the end of December 2005, a total of 600 patients and 135 staff members were found to be newly colonized. The yearly incidence of cases of MRSA colonization and infection decreased from 351 in 2002 to 56 in 2005. Typing of the isolates showed that 3 MRSA clones were predominant. Outbreaks of colonization involving these clones did not occur after 2003.

Conclusion.

Our observations show that strict application of “search-and-destroy” measures can effectively control a huge epidemic of MRSA colonization and infection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 8 , August 2007 , pp. 970 - 975
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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