Table 3 MRSA prevalence among patients in clinical settings
From: MRSA prevalence in european healthcare settings: a review
| NO. | Author, First | Study design | Screening policy | Results | Comments | Quality rating4 | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Country, Year of Publication | Study period (no. of months) | Study setting1(no. of units) (n) | Study population | Basic no. of cases potentially eligible/no. of participants (n) |
Screening methods (Origin of specimen) |
Swabbing sites | No. of MRSA patients colonised (C) or infected (I) or no. of isolates (n) | Prevalence of MRSA | |||||
|
% MRSA among patients Mean2(95% CI) Range3 | % MRSA among S.au reus isolates Mean2 | Density (no. of MRSA per 1,000 patients days | |||||||||||
| 12 |
Chaberny [46] Germany 2008 | 2005 (<1) | ICU (1), surgery (1), neurology (1), internal medicine (1) | Patients | 700/509 | On a given study day | Nares, throat, skin lesions | 27 (C) |
5.3 (3.5-7.7) ICU: 11.5a Surgery: 5.5a Neuro. 11.8 Int. med.: 5.1 | 19.0 | a Units with established admission screening |
Good 1Y; 2Y; 3Y; 4Y; 5Y; 6Y; 7Y | |
| 13 |
Chaberny [47] Germany 2005 |
2002 (12) | ICU (4) | Admissions | ?/188.615 |
On admission of patients at risk for MRSA Clinical samples5 | n.r. | 505 (C) 404 (I) | 0.48 |
0.64a
0.29a,b |
a Admissions b Noso-comial |
Fair 1Y; 2Y; 3N; 4Y; 5N; 6Y; 7? | |
| 14 |
Chaberny [7] Germany 2007 | 2004 (12) | Hospital (31) | Hospita-lized patients | ?/660.042 |
During hospital stay Clinical samples5 | Nares | 2.786 (C) 1.429 (I) |
0.71a
0.27a,b |
a Admissions b Noso-comial |
Fair 1Y; 2Y; 3Y; 4N; 5Y; 6N; 7N | ||
| 15 |
Eveillard [48] France 2002 | 2000 (1) | Acute geriatric ward (2) | Patients | 244/239 | On the first day of admission | Nares, wounds | 35 (C) | 14.6 (10.1-19.1) |
Fair 1N; 2Y; 3Y; 4Y; 5N; 6N; 7N | |||
| 16 |
Anonymous [49] Germany 2010 | 2008 (1) | RC (6), GH (8) | Patients | ?/6.985 | On admission during initial exa-mination |
Nose, throat | 95 (C) |
RC: 2.1 GH: 1.2 |
RC: 9.4 GH: 5.5 |
Fair 1N; 2Y; 3Y; 4N; 5N; 6?; 7Y | ||
| 17 |
Hassan [50] Ireland 2008 | 2005 (3) | Orthopedic ward (2) | Patients | 690/686 | Within 24 hrs of admission | Nose, perineum, surgical wounds | 27 (C) | 3.9 |
Fair 1N; 2N; 3Y; 4Y; 5N; 6Y; 7N | |||
| 18 |
Hori [14] UK 2002 | 2000 (4) | UH (1) | Patients older than 64 years | 431/342 | On the 21st day after admission | Nares | 54 (C) | 15.8 |
Fair 1N; 2Y; 3Y; 4Y; 5Y; 6N; 7N | |||
| 19/1 |
Kappstein [51] Germany 2009 | 2000-2005 (72) | UH (1) | Patients | ? |
On admission Clinical samples5 | Nose | 489 (C) 38 (I) | 0.42 |
Poor 1Y; 2N; 3N; 4N; 5N; 6N; 7N | |||
| 19/2 |
Kappstein [51] Germany 2009 | 2002-2005 (42) | UH (1) | Patients | 141.249/29.692 |
Within 48 hrs of admission | Nose, wounds | 231 (C) | 0.78 | ||||
| 20 |
Kresken [26] Germany 2009 |
2007 (1) | LF (26) | S. aureus isolates | ?/872 | Clinical samples5 | 159 isolates | 20.3 |
Poor 1N; 2Y; 3Y; 4N; 5N; 6N; 7N | ||||
| 21 |
Lucet [52] France 2009 |
2003-2004 (14) | Hospitals for primary and tertiary care (16) | Patients at discharge to home care, > 48 hrs in hospitala | 2.025/1.501 |
Within 3 days before discharge | Nose, chronic skin lesions | 191 (C) |
12.7 (11.0-14.5) | a Obstetric patients excluded |
Fair 1Y; 2N; 3Y; 4Y; 5Y; 6Y; 7N | ||
| 22 |
Lucet [53] France 2005 |
2002 (3,5) | Acute care ward in a hospital (1) | Patients older than 75 years, > 24 hrs in hospital | 1.434/797 | Within 48 hrs of admission |
Nose, skin breaks | 63 (C) |
7.9a
(6.0-9.8) | 29.7a | a Admissions |
Fair 1Y; 2N; 3Y; 4Y; 5Y; 6Y; 7N | |
| 23 |
Meyer [54] Germany 2006 |
2001-2004 (48) | ICU (40) | S. aureus isolates of patients with noso-comial infections | ?/12.238 | Clinical samples5 | 2.631 isolates | 21.5 | 4.4 |
Good 1Y; 2Y; 3Y; 4Y; Y5; 6N; 7N | |||
| 24 |
Morange-Saussier [55] France 2006 |
2004 (4) | Vascular surgery (1) |
Patients, > 24 hrs in hospital | ?/308 | On admission and 1 wk thereafter | Nares | 13 (C) | 4.2 | 27.0 |
Fair 1Y; 2Y; 3Y; 4Y; 5N; 6N; 7N | ||
| 25 |
Gopal Rao [29] UK 2007 |
2004- 2005 (12) | GH (1); emergency department | Adult emergency admissions | 13.826/7.801 | Prior to admission |
Nose, axillae |
670 (C) 433 (C) |
8.6a
6.7b |
a Admissions b Patients |
Fair 1N; 2Y; 3Y; 4Y; 5Y; 6N; 7N | ||
| 26 |
Reilly [56] UK 2010 |
2008 (5) | GH (6) | Emergency (68%) and elective (32%) admissions | 29.690/26.160 | On admission or at pre-admission (7.5%) | Nose, wounds, invasive device sites | 988 (C+I) |
3.8a
(3.5-4.0) | a Admissions |
Fair 1N; 2N; 3Y; 4Y; 5Y; 6Y; 7N | ||
| 27 |
Tai [57] UK 2004 |
2000 (12) | Orthopedic and trauma surgery (1) |
Patients at high risk for MRSA | 1.879/121 |
On admission Clinical samples5 |
Nose, throat, axillae, groins, wounds |
10 (C) 21 (I) | 1.6 |
Poor 1Y; 2N; 3Y; 4N; 5N; 6N; 7N | |||
| 28 |
Thompson [58] UK 2004 |
2001-2004 (30) | ICU (1) | Admissions to ICU | 1.472/1.361 |
On admission Weekly screening cycle Clinical samples5 | Nose, groins |
119 (C+I) 68 (C+I)b | 8.7a (6.1-10.2) |
a Admissions b Nosocomial Incidence: 1st wk: 7.5%; 2nd to 4th wk: 20.3% |
Fair 1Y; 2?; 3Y; 4?; 5Y; 6N; 7N | ||
| 29 |
Tiemersma [3] Germany 2004 |
1999-2002 (36) | Hospitals (25) | S. aureus blood isolates | ?/3.757 | Blood cultures5 | 600 isolates | 13.8 |
Poor 1Y; 2?; 3N; 4Y; 5N; 6N; 7N | ||||
| 30 |
Vos [59] NL 2009 |
2000-2004 (60) | UH (1) |
Admissions at high risk for MRSA |
?/ 21.598 | On admission | Nose, throat, perineum, invasive devices, wounds | 123 (C) | 0.10 | 0.0028a | a Related to bacteremia cases |
Fair 1N; 2Y; 3Y; 4N; 5Y; 6N; 7Y | |
| 31 |
Walley [60] UK 2009 |
2003 (3) | Trauma and ortho-pedic ward (1) |
Elective and trauma patients, > 48 hrs in hospital | 559/323 | Within 24-48 hrs of admission | Nose, perineum | 78 (C) | 24.0 |
Fair 1Y; 2N; 3Y; 4Y; 5Y; 6?; 7N | |||
| 11/2 |
Woltering [45] Germany 2008 |
GH (5), RC (3) | Patients | 1.321/818 |
On a 2-days screening period in each unit | Nose, throat, wounds |
GH: 17 (C) RC: 6 (C) |
GH: 3.4 (2.1-5.6) RC: 1.2 (0.4-3.3) |
GH: 11.6 RC: 5.6 |
Good 1N; 2Y; 3Y; 4Y; 5Y; 6N; 7Y | |||
