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Methicillin‐Resistant Staphylococcus aureus in French Hospitals: A 2‐Month Survey in 43 Hospitals, 1995
Hôpital Propre II Study Group
Infection Control and Hospital Epidemiology
Vol. 20, No. 7 (July 1999), pp. 478-486
Published by: Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America
Stable URL: http://www.jstor.org/stable/10.1086/501656
Page Count: 9
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OBJECTIVE. To estimate the incidence of methicillinresistant 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 publicaffiliated hospitals throughout France, including 12 universityaffiliated 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.
© 1999 by The Society for Healthcare Epidemiology of America. All rights reserved.