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Methicillin-Resistant Staphylococcus Aureus Carriage Among Patients After Hospital Discharge

Published online by Cambridge University Press:  21 June 2016

Menno R. Vriens ,
Hetty E. M. Blok ,
Ada C. M. Gigengack-Baars ,
Ellen M. Mascini ,
Chris van der Werken ,
Jan Verhoef  and
Annet Troelstra
Menno R. Vriens
Affiliation:
University Medical Center Utrecht, Department of Surgery, Utrecht, the Netherlands University Medical Center Utrecht, Eijkman-Winkler Center for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene and Infection Prevention, Utrecht, the Netherlands
Hetty E. M. Blok*
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Center for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene and Infection Prevention, Utrecht, the Netherlands
Ada C. M. Gigengack-Baars
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Center for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene and Infection Prevention, Utrecht, the Netherlands
Ellen M. Mascini
Affiliation:
Microbiological and Immunological Laboratory, Rijnstate Hospital, Arnhem, the Netherlands
Chris van der Werken
Affiliation:
University Medical Center Utrecht, Department of Surgery, Utrecht, the Netherlands
Jan Verhoef
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Center for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene and Infection Prevention, Utrecht, the Netherlands
Annet Troelstra
Affiliation:
University Medical Center Utrecht, Eijkman-Winkler Center for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene and Infection Prevention, Utrecht, the Netherlands
*
University Medical Center Utrecht, ZHIP, HP G 04.614, P.O. Box 85500, 3508 GA Utrecht, the Netherlands.H.E.M.Blok@lab.azu.nl
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Abstract

Background and Objective:

At the University Medical Center Utrecht (UMCU), follow-up implies an inventory of risk factors and screening for MRSA colonization among all MRSA-positive patients for at least 6 months. If risk factors or positive cultures persist or re-emerge, longer follow-up is indicated and isolation at readmission. This study investigated how long MRSA-positive patients remained colonized after hospital discharge and which risk factors were important. Furthermore, the results of eradication therapy were evaluated.

Design:

All patients who were positive for MRSA at the UMCU between January 1991 and January 2001 were analyzed regarding carriage state, presence of risk factors for prolonged carriage of Staphylococcus aureus, and eradication treatment.

Results:

A total of 135 patients were included in the study. The median follow-up time was 1.2 years. Eighteen percent of the patients were dismissed from follow-up 1 year after discharge. Only 5 patients were dismissed after 6 months. Among patients with no risk factors, eradication treatment was effective for 95% within 1 year. Among patients with persistent risk factors, treatment was effective for 89% within 2 years.

Conclusions:

Based on these findings, eradication therapy should be prescribed for all MRSA carriers, independent of the presence of risk factors. MRSA-positive patients should be evaluated for 6 months for the presence of risk factors and MRSA carriage. Screening for risk factors is important because intermittent MRSA carriage was found in a significant number of our patients. Patients with negative MRSA cultures and without risk factors for 12 months can be safely dismissed from follow-up. (Infect Control Hosp Epidemiol 2005;26:629-633)

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 7 , July 2005 , pp. 629 - 633
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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