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NHSN Annual Update:
Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections

Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007

Antimicrobial-resistant pathogens that cause healthcare-associated infections (HAIs) pose an ongoing and increasing challenge to hospitals, both in the clinical treatment of patients and in the prevention of the cross-transmission of these problematic pathogens.  Describing the magnitude of the problem with respect to these antimicrobial-resistant pathogens is challenging, because the levels of antimicrobial resistance vary for different types of healthcare facilities and for different geographic areas, and some resistance phenotypes are difficult for laboratories to detect. However, the findings from such attempts may help the infection control and public health communities target problems and utilize resources more efficiently.

In the News

Featured in The Times
"Ireland 'losing war' on superbug" February 15, 2009
Challenges of Implementing National Guidelines for the Control and Prevention of Methicillin‐Resistant Staphylococcus aureus Colonization or Infection in Acute Care Hospitals in the Republic of Ireland
Fidelma Fitzpatrick, MD; Fiona Roche, PhD; Robert Cunney, MB; Hilary Humphreys, MD; Strategy for the Control of Antimicrobial Resistance in Ireland Infection Control Subcommittee
The research, published in Infection Control and Hospital Epidemiology, found one third of hospitals did not have a written policy on antibiotic use, and only 35% had an antibiotic stewardship programme.

August 2007

Volume 28, Number 8
Infect Control Hosp Epidemiol 2007;28:970–975
0899-823X/2007/2808-0013$15.00
DOI: 10.1086/519210
Original Article

Successful Control of Widespread Methicillin‐Resistant Staphylococcus aureus Colonization and Infection in a Large Teaching Hospital in The Netherlands

M. J. C. A. van Trijp, MD, PhD;

D. C. Melles, MD;

W. D. H. Hendriks, MD, PhD;

G. A. Parlevliet, MD, PhD;

M. Gommans, MD, PhD;

A. Ott, MD, PhD

From the Laboratory for Medical Microbiology, Medical Center Rijnmond‐Zuid (M.J.C.A.v.T., W.D.H.H., M.G.), the Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, University Medical Center (M.J.C.A.v.T., D.C.M., G.A.P., A.O.), Rotterdam, and the Laboratory for Infectious Diseases, Groningen (A.O.), The Netherlands.

Objective.The low prevalence of infection and colonization with methicillin‐resistant Staphylococcus aureus (MRSA) in The Netherlands is ascribed to a national “search‐and‐destroy” policy. We describe the measures that were implemented to control widespread MRSA colonization and infection in a Dutch hospital.

Design.Descriptive intervention study.

Setting.Teaching medical center with a capacity of 679 beds, including 16 intensive care beds.

Interventions.MRSA colonization and infection were identified using conventional culture with a selective broth. Isolates were typed using pulsed‐field gel electrophoresis. Measures to control the epidemic included screening of contacts (patients and hospital staff), screening of patients at readmission or discharge, strict isolation of MRSA‐positive patients, decolonization of colonized staff and patients, the development of an electronic signal identifying MRSA‐positive patients, and the development of a culture information–system for hospital personnel.

Results.Awareness of uncontrolled dissemination of MRSA began in November 2001. Because the clone involved had a low minimum inhibitory concentration for oxacillin, at first it was not recognized as MRSA. In February 2002, when major screening efforts started, it appeared that MRSA had spread all over the hospital and that many staff members were colonized. By the end of December 2005, a total of 600 patients and 135 staff members were found to be newly colonized. The yearly incidence of cases of MRSA colonization and infection decreased from 351 in 2002 to 56 in 2005. Typing of the isolates showed that 3 MRSA clones were predominant. Outbreaks of colonization involving these clones did not occur after 2003.

Conclusion.Our observations show that strict application of “search‐and‐destroy” measures can effectively control a huge epidemic of MRSA colonization and infection.

Received November 27, 2006; accepted March 5, 2007; electronically published June 19, 2007.

Address reprint requests to Marijke J.C.A. van Trijp, Medical Center Rijnmond‐Zuid, Laboratory of Medical Microbiology, Olympiaweg 350, 3078 HT Rotterdam, The Netherlands ().

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