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Correlation between meticillin-resistant Staphylococcus aureus prevalence and infection control initiatives within
M A Borg1, B D Cookson, O Rasslan
1Infection Control Unit, Mater Dei Hospital, Msida, Malta. michael.a.borg@gov.mt
Abstract:
The Mediterranean region has been identified as an area of hyper-endemicity for multi-resistant hospital pathogens. To better understand potential drivers behind this situation, we attempted to correlate already published meticillin-resistant Staphylococcus aureus (MRSA) data from 27 hospitals, participants in the Antibiotic Resistance Surveillance & Control in the Mediterranean Region (ARMed) project, with responses received from the same institutions to questionnaires which dealt with various aspects of infection control and antibiotic stewardship. No difference could be ascertained between high and low prevalence hospitals in terms of scores from replies to structured questions regarding infection control set-up, hand hygiene facilities and antibiotic stewardship practices. However, we did identify differences in terms of bed occupancy and isolation facilities. Hospitals reporting frequent episodes of overcrowding, particularly involving several departments, and which found regular difficulties sourcing isolation beds, had significantly higher MRSA proportions. This suggests that infrastructural deficits related to insufficient bed availability and compounded by inadequate isolation facilities could potentiate MRSA hyper-endemicity in south-eastern Mediterranean hospitals.
Insights
Hospital overcrowding and limited isolation beds significantly increase methicillin-resistant Staphylococcus aureus (MRSA) in Mediterranean hospitals. Infrastructure deficits, not infection control practices, appear to drive hyper-endemicity.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Public Health
Background:
- The Mediterranean region faces high rates of multi-resistant hospital pathogens.
- Meticillin-resistant Staphylococcus aureus (MRSA) is a significant concern in this area.
Purpose of the Study:
- To identify drivers of high MRSA prevalence in Mediterranean hospitals.
- To correlate MRSA data with infection control and antibiotic stewardship practices.
Main Methods:
- Analysis of published MRSA data from 27 hospitals in the ARMed project.
- Correlation with questionnaire responses on infection control and antibiotic stewardship.
- Comparison between high and low MRSA prevalence hospitals.
Main Results:
- No significant differences in infection control, hand hygiene, or stewardship scores.
- Higher MRSA prevalence linked to frequent hospital overcrowding.
- Difficulties in sourcing isolation beds correlated with increased MRSA proportions.
Conclusions:
- Infrastructural deficits, specifically bed availability and isolation capacity, are key factors in MRSA hyper-endemicity.
- Overcrowding and inadequate isolation facilities potentiate MRSA spread in southeastern Mediterranean hospitals.
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