Methicillin-resistant Staphylococcus aureus in Saarland, Germany: a statewide admission prevalence screening study

PLoS One. 2013 Sep 11;8(9):e73876. doi: 10.1371/journal.pone.0073876. eCollection 2013.

Abstract

Background: The screening of hospital admission patients for methicillin resistant Staphylococcus aureus (MRSA) is of undisputed value in controlling and reducing the overall MRSA burden; yet, a concerted parallel universal screening intervention throughout all hospitals of an entire German Federal State has not yet been performed.

Methodology/principal findings: During a four-week period, all 24 acute care hospitals of the State of Saarland participated in admission prevalence screening. Overall, 436/20,027 screened patients revealed MRSA carrier status (prevalence, 2.2/100 patients) with geriatrics and intensive care departments associated with highest prevalence (7.6/100 and 6.3/100, respectively). Risk factor analysis among 17,975 admission patients yielded MRSA history (OR, 4.3; CI₉₅ 2.7-6.8), a skin condition (OR, 3.2; CI₉₅ 2.1-5.0), and/or an indwelling catheter (OR, 2.2; CI₉₅ 1.4-3.5) among the leading risks. Hierarchical risk factor ascertainment of the six risk factors associated with highest odd's ratios would require 31% of patients to be laboratory screened to allow for detection of 67% of all MRSA positive admission patients in the State.

Conclusions/significance: State-wide admission prevalence screening in conjunction with risk factor ascertainment yields important information on the distribution of the MRSA burden for hospitals, and allows for data-based decisions on local or institutional MRSA screening policies considering risk factor prevalence and expected MRSA identification rates.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cost-Benefit Analysis
  • Cross Infection / epidemiology
  • Female
  • Germany / epidemiology
  • Hospital Departments
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Methicillin-Resistant Staphylococcus aureus* / classification
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Sex Factors
  • Staphylococcal Infections / epidemiology*
  • Staphylococcus aureus
  • Young Adult

Grants and funding

The study has been funded by two funding bodies, the German Ministry of Health and the State of Saarland Government. Neither funding body had a role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The acknowledgment of one of the coauthors (R.K.) is solely for the purpose of declaring her employment by the State of Saarland Ministry of Social Affairs, Health, Women and Families (part of the State of Saarland Government); it does not impede above statement.