[Methicillin-resistant Staphylococcus aureus in repatriates from the Faro airplane crash, 1992]

To review the suitability of the guidelines of the Working Group Infection Prevention (WIP) and the Medical Inspectorate of Health with regard to possible methicillin-resistant Staphylococcus aureus (MRSA) contamination.

Medical Inspectorate of Health.

Retrospective analysis.

For 95 repatriates from the Faro air crash, a questionnaire was filled out by medical microbiologists and attending specialists in Dutch hospitals (response rate: 100%). Classification for MRSA risk category was done in accordance with the guidelines of the Medical Inspectorate of Health. Surveillance data of the National Institute of Public Health and Environmental Protection were consulted.

Colonisation with MRSA occurred in 8 out of the 59 patients in the high-risk group (hospitalisation > 24 h in Portugal or invasive procedures). No MRSA was found in the low-risk group (all other repatriates). The MRSA-positive patients had burns at least. Infection was detected in three patients on admission, in five patients later (after 6-27 days of hospitalisation), after 1-9 negative cultures. Probably all patients had been contaminated with MRSA in Portugal. In two Dutch hospitals secondary contamination was observed.

The WIP guidelines on MRSA control proved to be sufficient with exception of the inventory cultures and the isolation measures notably for patients with covered wounds. The MRSA risk classification of patients according to the guidelines of the Medical Inspectorate of Health proved adequate.