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Methicillin-Resistant Staphylococcus Aureus in French Hospitals: A 2-Month Survey in 43 Hospitals, 1995

Published online by Cambridge University Press:  02 January 2015

The Hôpital Propre II Study Group
The Hôpital Propre II Study Group
Affiliation:
Service de Réanimation Médicale and Unité d'Hygiène et Prevention de l'Infection, Hôpital Henri Mondor, Créteil, France
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Abstract

Objective:

To estimate the incidence of methicillin-resistant Staphylococcus aureus (MRSA) in patients hospitalized in French public hospitals.

Design:

A 2-month survey that included 163,573 patients and 140,114 admissions.

Setting and Patients:

Forty-three public or public-affiliated hospitals throughout France, including 12 university-affiliated hospitals. Information was recorded on all patients having MRSA recovered from culture of any clinical sample.

Results:

The overall median incidence rate (per 1,000 admissions) of clinically detected MRSA was 5.9 (range, 1.8-15.8); median rates were similar in hospitals affiliated or not affiliated to universities (6.4 and 5.9, respectively). Smaller unaffiliated hospitals (<500 beds) had higher MRSA incidence rates (mean, 7.2) than larger (>500 beds) unaffiliated hospitals or university hospitals (mean, 6.7 and 6.1, respectively). The incidence density (per 1,000 patient-days) of MRSA was higher in intensive-care units [ICUs] 2.39/1,000) than in surgical (0.80/1,000) and medical (0.70/1,000) wards, respectively; comparable rates were recorded in rehabilitation units (0.67/1,000), whereas in long-term-stay units, the incidence density of MRSA was 0.27/1,000 patient-days. Of 958 MRSA isolates, 660 (69%) also were resistant to all aminoglycosides. In 411 (43%) of 958 patients, the MRSA isolate was considered imported (ie, first recovered within 72 hours of the patient's admission to the unit). More than one half (53%) of imported cases were transfer patients from other hospitals, and 17% originated from ICUs.

Conclusion:

MRSA is extensive in French hospitals. All categories of hospitals are involved to a similar extent, and there is intense circulation of patients colonized or infected with MRSA between units and hospitals. Containment of MRSA would mandate increasing resources devoted to infection control, especially in smaller hospitals, and control programs should involve notification of carriers and screening of patients at risk of MRSA carriage on admission to detect carriers and to implement isolation precautions rapidly.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 7 , July 1999 , pp. 478 - 486
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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References

1.Jevons, MP. “Celbenin”-resistant staphylococci. BMJ 1961;1:124–125.Google Scholar
2.Townsend, DE, Ashdown, N, Bolton, S. The international spread of methicillin-resistant staphylococci. J Hosp Infect 1987;9:60–71.Google Scholar
3.Voss, A, Milatovic, D, Wallrauch-Schwartz, C, Rosdahl, VT, Braveny, I. Methicillin-resistant Staphylococcus aureus in Europe. Eur J Clin Microbiol Infect Dis 1994;13:50–55.Google Scholar
4.Ayliffe, GAJ. The progressive intercontinental spread of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 1997;24:S74–S79.Google Scholar
5.Boyce, JM. Should we vigorously try to contain and control methicillin-resistant Staphylococcus aureus? Infect Control Hosp Epidemiol 1991;12:46–54.CrossRefGoogle ScholarPubMed
6.Jernigan, JA, Clemence, MA, Stott, GA, Titus, MG, Alexander, CH, Palumbo, CM, et al. Control of methicillin-resistant Staphylococcus aureus at a university hospital: one decade later. Infect Control Hosp Epidemiol 1995;16:686–696.Google Scholar
7.Hollis, RJ, Barr, JL, Doebbeling, BN, Pfaller, MA, Wenzel, RP. Familial carriage of methicillin-resistant Staphylococcus aureus and subsequent infection in a premature neonate. Clin Infect Dis 1995;21:328–332.Google Scholar
8.Fraise, AP, Mitchell, K, O'Brien, SJ, Oldfield, K, Wise, R. Methicillin-resistant Staphylococcus aureus (MRSA) in nursing homes in a major UK city: an anonymized point prevalence survey. Epidemiol Infect 1997;118:1–5.CrossRefGoogle Scholar
9.Thompson, RL, Cabezudo, I, Wenzel, RP. Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med 1982;97:309–317.Google Scholar
10.Bradley, SF, Terpenning, MS, Ramsey, MA, Zarins, LT, Jorgensen, KA, Sottile, WS, et al. Methicillin-resistant Staphylococcus aureus: colonization and infection in a long-term care facility. Ann Intern Med 1991;115:417–422.Google Scholar
11.Linnemann, CC, Moore, P, Staneck, JL, Pfaller, MA. Reemergence of epidemic methicillin-resistant Staphylococcus aureus in a general hospital associated with changing staphylococcal strains. Am J Med 1991;91:238S–244S.CrossRefGoogle Scholar
12.Steinberg, JP, Clark, CC, Hackman, BO. Nosocomial and community-acquired Staphylococcus aureus bacteremia from 1980 to 1993: impact of intravascular devices and methicillin resistance. Clin Infect Dis 1996;23:255–259.Google Scholar
13.Rosdahl, VT, Knudsen, AM. The decline of methicillin resistance among Danish Staphylococcus aureus strains. Infect Control Hosp Epidemiol 1991;12:83–88.CrossRefGoogle ScholarPubMed
14.Vanderbroucke-Grauls, CMJE. Methicillin-resistant Staphylococcus aureus control in hospitals: the Dutch experience. Infect Control Hosp Epidemiol 1996;17:512–513.Google Scholar
15.Boyce, JM. Increasing prevalence of methicillin-resistant Staphylococcus aureus in the United States. Infect Control Hosp Epidemiol 1990;11:639–642.Google Scholar
16.Struelens, MJ, Ronveaux, O, Jans, B, Mertens, R, Groupement pour le Dépistage, l'Etude et la Prevention des Infections Hospitalieres. Methicillin-resistant Staphylococcus aureus epidemiology and control in Belgian hospitals, 1991 to 1995. Infect Control Hosp Epidemiol 1996;17:503–508.Google Scholar
17.Johnson, Z, Fitzpatrick, P, Hayes, C, Sayers, G, Pelly, H, McDonnel, B, et al. National survey of MRSA: Ireland, 1995. J Hosp Infect 1997;35:175–184.Google Scholar
18.Richet, H, Wiesel, M, Le Gallou, F, Andre-Richet, B, Espaze, E. Methicillin-resistant Staphylococcus aureus control in hospitals: the French experience. Association des Pays de la Loire pour l'Eviction des Infections Nosocomiales. Infect Control Hosp Epidemiol 1996;17:509–511.Google Scholar
19.Le Coustumier, A, Gueudet, P, Lecaillon, E, Bland, S, Hanesse, B, Collège de Bactériologie V, et Hygiène des Hôpitaux de France. Incidence de Staphylococcus aureus méticilline-résistant dans 95 hôpitaux non universitaires en France. Medecine & Maladies Infectieuses (Paris) 1996;26:634–643.Google Scholar
20.Cailleaux, V, Talon, D, Thouverez, M, Bailly, P, Mulin, B, Michel-Briand, Y. Staphylococcus aureus méticillino-résistant: importance et transmission croisée dans l'Est de la France. Médecine & Maladies Infectieuses (Paris) 1996;26:475–481.Google Scholar
21.Collège de Bactériologie-Virologie-Hygiène du CHU de Paris. Surveillance des staphylocoques dorés et klebsielles multirésistantes à l'Assistance Publique-Hôpitaux de Paris (1993-1996). Bulletin Epidémiologique Hebdomadaire (Paris) 1998;41–43.Google Scholar
22.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.Google Scholar
23.Aubry-Damon, H, Legrand, P, Brun-Buisson, C, Astier, A, Soussy, CJ, Leclercq, R. Reemergence of gentamicin-susceptible strains of methicillin-resistant Staphylococcus aureus: roles of an infection control program and changes in aminoglycoside use. Clin Infect Dis 1997;25:647–653.Google Scholar
24.Lemaître, N, Sougakoff, W, Masmoudi, A. Fievet, M-H, Bismuth, R, Jarlier, V. Characterization of nosocomial spread of methicillin-resistant Staphylococcus aureus involved in nosocomial spread. J Clin Microbiol 1998;36:81–85.Google Scholar
25.Muder, RR, Brennen, C, Wagener, MM, Vickers, RM, Rihs, JD, Hancock, GA, et al. Methicillin-resistant staphylococcal colonization and infection in a long-term care facility. Ann Intern Med 1991;114:107–112.Google Scholar
26.Kauffman, CA, Bradley, SF, Terpenning, MS. Methicillin-resistant Staphylococcus aureus in long-term care facilities. Infect Control Hosp Epidemiol 1990;11:600–603.Google Scholar
27.Hoefnagels-Schuermans, A, Borremans, A, Peetermans, WE, Van Lierde, S, Reybrouck, G, Van Eldere, J. Origin and transmission of methicillin-resistant Staphylococcus aureus in an endemic situation: differences between geriatric and intensive-care patients. J Hosp Infect 1997;36:209–222.Google Scholar
28.Strausbaugh, LJ, Jacobson, C, Sewell, DL, Potter, S, Ward, TT. Methicillin-resistant Staphylococcus aureus in extended-care facilities: experiences in a Veterans' Affairs nursing home and a review of the literature. Infect Control Hosp Epidemiol 1991;12:36–45.Google Scholar
29.Thomas, JC, Bridge, J, Waterman, S, Vogt, J, Kilman, L, Hancock, G. Transmission and control of methicillin-resistant Staphylococcus aureus in a skilled nursing facility. Infect Control Hosp Epidemiol 1989;10:106–110.Google Scholar
30.Coello, R, Jiménez, J, Garcia, M, Arroyo, P, Minguez, D, Fernandez, C, et al. Prospective study of infection, colonization and carriage of methicillin-resistant Staphylococcus aureus in an outbreak affecting 990 patients. Eur J Clin Microbiol Infect Dis 1994;13:74–81.Google Scholar
31.Girou, E, Pujade, G, Legrand, P, Cizeau, F, Brun-Buisson, C. Selective screening of carriers for control of methicillin-resistant Staphylococcus aureus (MRSA) in high-risk hospitals areas with a high-level of endemic MRSA. Clin Infect Dis 1998;27:543–550.Google Scholar
32.Struelens, MJ, Mertens, R. The Groupement pour le Dépistage, l'Etude et la Prevention des Infections Hospitalieres. National survey of methicillin-resistant Staphylococcus aureus in Belgian hospitals: detection methods, prevalence trends and infection control measures. Eur J Clin Microbiol Infect Dis 1994;13:56–63.Google Scholar