Antibiotics: MRSA prevention measures in German hospitals: results of a survey among hospitals, performed as part of the MRSA-KISS module.

BACKGROUND In this study, we investigated the measures currently being taken in German hospitals to prevent infection with methicillin-resistant strains of Staphylococcus aureus (MRSA). To this end, we circulated a questionnaire among hospitals participating in the MRSA-KISS module. "KISS" in the name of this project stands for "hospital infection surveillance system" (in German, Krankenhaus-Infektions-Surveillance-System). METHODS The questionnaire was sent to all MRSA-KISS participants. A study doctor visited a representative sample of hospitals to validate the responses. The study doctor checked the questionnaire responses with a systematic on-site interview of the contact person in each hospital, then evaluated the information contained in them by recording all of the MRSA patients who were present in the hospital on the day of the visit in a point-prevalence study (PPS). RESULTS All 134 participants filled out the questionnaire. The screening of patients at risk on admission is an established part of the clinical routine in all of the surveyed hospitals, as are MRSA decolonization procedures. These preventive measures have been recommended for routine use in Germany by the Robert Koch Institute (RKI, the German counterpart of the Centers for Disease Control and Prevention). The surveyed hospitals also used further preventive strategies, including, for example, an alerting system for the identification, upon hospital admission, of patients with a known history of MRSA positivity (72%); pre-admission screening of all patients (13%); universal screening on admission in some hospital wards (19%); and the prophylactic isolation of patients suspected of having MRSA with pending microbiological test results (21%). 35 hospitals were visited for validation. Most of the responses in each hospital were internally consistent and adequately reflected the real situation on site. Less consistency was seen in responses regarding the detection of MRSA by clinical testing and the measures that were taken after MRSA was detected. CONCLUSION The surveyed hospitals are, in fact, implementing many of the RKI's recommendations, as well as other preventive measures against MRSA.