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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
  1. 1: UH = University hospital, ICU = Intensive care unit, TH = Teaching hospital, GH = General hospital, RC = Rehabilitation centre, LF = Laboratory facility, n.r. = not reported.
  2. 2: Pooled mean calculated as a combined prevalence rate over all units with 95% CI.
  3. 3: Range within the individual units.
  4. 4: Levels for study quality: Good (= 6 and 7 points), fair (= 3 - 5 points), poor (= 1 and 2 points). Numbers belong to the questions as illustrated in Table 1.
  5. 5: Specimens (blood, sputum, others) taken for diagnostic purposes. Abbreviations: CI, Confidence intervals; hrs, hours; N, no; wk, week; Y, Yes; ?, unclear or missing information.