The continuing problem of 'hospital staphylococci': why?

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Hospital Epidemiology

Background:

• Nosocomial infections caused by staphylococci, particularly methicillin-resistant Staphylococcus aureus (MRSA), present a significant global health challenge.
• The incidence of MRSA is notably high in Japan compared to Europe, and coagulase-negative staphylococci (CNS) are increasingly implicated in infections linked to prosthetic implants.
• Hospital staff hand carriage is a suspected route for introducing CNS onto medical devices like catheters and intravenous lines.

Purpose of the Study:

• To evaluate the effectiveness and cost-efficiency of prophylactic strategies in controlling the spread of nosocomial Staphylococcus infections.
• To highlight the economic benefits of infection prevention compared to treatment.

Main Methods:

• Review of control measures implemented in the UK, focusing on reservoirs of infection.
• Analysis of data from North Middlesex Hospital, London, regarding an aggressive prophylactic policy for MRSA initiated in 1987.
• Comparative cost analysis of treating MRSA carriers versus infected patients.

Main Results:

• Prophylactic measures are crucial for preventing infection, reducing morbidity, mortality, and economic burden.
• Treating a methicillin-resistant Staphylococcus aureus (MRSA) carrier is six times less expensive than treating an infected patient.
• An aggressive prophylactic policy for MRSA has been in place since 1987 at North Middlesex Hospital.

Conclusions:

• Prophylaxis is a more cost-effective approach to controlling the spread of MRSA infection than treating active infections.
• Stringent control strategies, increased awareness, and adequate funding are essential to limit the dissemination of resistant bacteria.
• Effective control of nosocomial Staphylococcus infections requires a multi-faceted approach targeting reservoirs and implementing preventative measures.