[Methicillin resistant Staphylococcus aureus in nursing homes.]

Abstract niet beschikbaarIn the Netherlands on the average 10.000 nursing home patients are admitted to hospitals yearly. The aim of this study was to obtain an insight in the prevalence of methicillin resistant Staphylococcus aureus (MRSA) among Dutch nursing home patients. For this purpose nose cultures were taken from 819 physically disabled nursing home patients in seventeen nursing homes. The nursing homes were all situated in a relative risk area for MRSA: MRSA-strains were isolated frequently in affiliated hospitals. Risk factors for (persistent) MRSA-carriage were evaluated as well as the age and sex of the nursing home patients. The prevalence of MRSA turned out to be very low ; only from one nursing home patient a MRSA strain was isolated.GH

Surveillance of methicillin-resistant Staphylococcus aureus in the Netherlands in 1991

The surveillance of methicillin-resistant Staphylococcus aureaus (MRSA) in Dutch hospitals was continued in 1991. In this year 211 MRSA-isolates were received from fifty-three hospitals. Phage-pattern and antibiogram were determined for all MRSA-isolates. Sixty-six different phage-types were found. Of these, eleven phage-types were isolated in two or more hospitals. Five MRSA phage-types have been isolated in 1989 as well as in 1990 and 1991. For approximately 60% of the MRSA phage-types the origin was reported in 1991. Nearly half of them were introduced from foreign hospitals. Some MRSA phage-types originate from several countries. MRSA-isolates are usually multi-resistant. Resistance percentages in 1991 are more or less similar to those in 1989 and 1990. Although, still infrequent the occurrence of fusidic acid resistant strains should be notified. Decreased susceptibility to mupirocin was incidentally found.GH

Surveillance of methicillin resistant Staphylococcus aureus in the Netherlands in 1990

Follow-up studies on the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Dutch hospitals were continued in 1990. The number of MRSA-isolates in 1990 compared to 1989 is approximately the same. Phage-type pattern and antibiogram were determined for 168 MRSA-isolates from 42 hospitals. Based on epidemiological knowledge the MRSA-strains of 1989 and 1990 can be subdivided into three groups. Six MRSA phage-types were found in more than one hospital (epidemic types) and five MRSA phage-types were found more than once in one hospital (endemic types). Other MRSA-strains have not spread in Dutch hospitals (sporadic types). The antibiograms of the most prevalent phage-types in 1990 are given in this paper. The origin of all new MRSA phage-types in 1990 has been assessed. In many cases a preceding admission to a foreign hospital or a Dutch nursinghome was observed before the introduction of the "new" MRSA-strain. The percentage of new MRSA-strains in Dutch hospitals is relatively low compared to the percentages in foreign hospitals. There is no data on the prevalence of multiresistant microorganisms (e.g. MRSA) in Dutch nursinghomes. Thorough patient registration, good inter-doctor communication and proper hygiene are all important factors in limitating hospital epidemics caused by MRSA-strains.RIVMGH

Surveillance of methicillin resitant Staphylococcus aureus in the Netherlands

Abstract niet beschikbaarA surveillance study on methicillin resistant Staphylococcus aureus (MRSA) in the Netherlands was started in January 1989 by the National Institute of Public Health & Environmental Protection (RIVM) in Bilthoven. Twenty-nine laboratories sent about 150 MRSA-isolates of patients and personnel in 1989. These isolates were phagetyped by the Laboratory for Bacteriology and M.I.C.-values for about 14 antibiotics were determined in the Laboratory for Chemotherapy. Thirty-two phagetypes were found of which twenty phagetypes were isolated only once. Of the more frequent phagetypes, expecially phagetypes "g" and "e", were by far most prevalent, being isolated fifty and fifty-five times respectively. Both phagetypes were associated with hospital epidemics in the Netherlands in and before 1989. Almost all MRSA- isolates were multiresistant strains. One third of the isolates was resistant to rifampicin, and only one fourth of MRSA-isolates was resistant to cotrimoxazole. All isolates were sensitive to fusidic acid and vancomycin. Introduction of a MRSA-strain into a Dutch hospital is often associated with transfer of patients, who have been nursed in a foreign hospital. They have been colonized with an "endemic" MRSA-strain in this hospital. Strict isolation procedures of these patients in Dutch hospitals are necessary till repeated routine cultures are negative for MRSA. In case of interhospital transfer of MRSA-poitive patients, good communication between the hospitals concerned is important. Multiresistant staphylococci are a serious problem in hospital epidemiology and treatment of associated infections.GHI RIV