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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Large variation in MRSA policies, procedures and prevalence in English intensive care units: a questionnaire analysis
Janeane Hails1, Felicia Kwaku, A Peter Wilson
1Bloomsbury Institute of Intensive Care Medicine, Jules Thorn Building, Middlesex Hospital, Mortimer St, London W1T 3AA, UK.
Objective:
Methicillin-resistant Staphylococcus aureus (MRSA) is a major problem in intensive care units in most countries. Despite recommendations for screening and isolation of patients with MRSA our perception has been that there is little uniformity in approach in ICUs besides adherence to basic infection control procedures. We thus sought to identify MRSA prevalence and the variation of infection control policy across intensive care units in England.
Design And Setting:
Postal questionnaire with telephone follow-up in English intensive care units.
Measurements And Results:
Responses were obtained from 217 (96%) ICUs. Marked variation in practice was noted in terms of patient screening, staff screening, infection control procedures, isolation or cohorting of colonised/infected patients, and ward discharge policy. Point prevalence data showed that 16.2% of ICU patients were known to be colonised or infected with MRSA. There was a regional bias, but no difference was noted between high and low prevalence regions in terms of unit demographics or infection control policies.
Conclusions:
This study highlights the lack of consistent policy across English ICUs regarding isolation, screening and discharge practices for MRSA. Prospective studies are urgently needed to determine best practice.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) infection control policies vary widely across English intensive care units (ICUs). This lack of uniformity in screening, isolation, and discharge practices for MRSA highlights a need for standardized best practices.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in intensive care units (ICUs) globally.
- Existing recommendations for MRSA screening and isolation are not uniformly implemented in ICUs.
- Perceived variability in MRSA management strategies necessitates an investigation into current practices.
Purpose of the Study:
- To determine the prevalence of MRSA in English intensive care units.
- To identify variations in infection control policies related to MRSA across these units.
Main Methods:
- A postal questionnaire was distributed to intensive care units in England.
- Telephone follow-up was conducted to ensure comprehensive data collection.
- The study surveyed practices including patient and staff screening, isolation, cohorting, and discharge policies.
Main Results:
- Responses were received from 217 (96%) of English ICUs.
- Significant variations in MRSA-related infection control practices were observed.
- The point prevalence of MRSA colonization or infection among ICU patients was 16.2%.
Conclusions:
- English ICUs demonstrate a lack of consistent policy regarding MRSA isolation, screening, and discharge.
- Despite regional differences in prevalence, unit demographics and policies did not significantly differ between high and low prevalence regions.
- Urgent prospective studies are required to establish evidence-based best practices for MRSA management in ICUs.
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