BACKGROUND AND OBJECTIVE: At the University Medical Center Utrecht (UMCU), follow-up implies an inventory of risk factors and screening for MRSA colonization among all MRSA-positive patients for at least 6 months. If risk factors or positive cultures persist or re-emerge, longer follow-up is indicated and isolation at readmission. This study investigated how long MRSA-positive patients remained colonized after hospital discharge and which risk factors were important. Furthermore, the results of eradication therapy were evaluated. DESIGN: All patients who were positive for MRSA at the UMCU between January 1991 and January 2001 were analyzed regarding carriage state, presence of risk factors for prolonged carriage of Staphylococcus aureus, and eradication treatment. RESULTS: A total of 135 patients were included in the study. The median follow-up time was 1.2 years. Eighteen percent of the patients were dismissed from follow-up 1 year after discharge. Only 5 patients were dismissed after 6 months. Among patients with no risk factors, eradication treatment was effective for 95% within 1 year. Among patients with persistent risk factors, treatment was effective for 89% within 2 years. CONCLUSIONS: Based on these findings, eradication therapy should be prescribed for all MRSA carriers, independent of the presence of risk factors. MRSA-positive patients should be evaluated for 6 months for the presence of risk factors and MRSA carriage. Screening for risk factors is important because intermittent MRSA carriage was found in a significant number of our patients. Patients with negative MRSA cultures and without risk factors for 12 months can be safely dismissed from follow-up.
BACKGROUND AND OBJECTIVE: At the University Medical Center Utrecht (UMCU), follow-up implies an inventory of risk factors and screening for MRSA colonization among all MRSA-positive patients for at least 6 months. If risk factors or positive cultures persist or re-emerge, longer follow-up is indicated and isolation at readmission. This study investigated how long MRSA-positive patients remained colonized after hospital discharge and which risk factors were important. Furthermore, the results of eradication therapy were evaluated. DESIGN: All patients who were positive for MRSA at the UMCU between January 1991 and January 2001 were analyzed regarding carriage state, presence of risk factors for prolonged carriage of Staphylococcus aureus, and eradication treatment. RESULTS: A total of 135 patients were included in the study. The median follow-up time was 1.2 years. Eighteen percent of the patients were dismissed from follow-up 1 year after discharge. Only 5 patients were dismissed after 6 months. Among patients with no risk factors, eradication treatment was effective for 95% within 1 year. Among patients with persistent risk factors, treatment was effective for 89% within 2 years. CONCLUSIONS: Based on these findings, eradication therapy should be prescribed for all MRSA carriers, independent of the presence of risk factors. MRSA-positive patients should be evaluated for 6 months for the presence of risk factors and MRSA carriage. Screening for risk factors is important because intermittent MRSA carriage was found in a significant number of our patients. Patients with negative MRSA cultures and without risk factors for 12 months can be safely dismissed from follow-up.
Authors: D O Morris; E Lautenbach; T Zaoutis; K Leckerman; P H Edelstein; S C Rankin Journal: Zoonoses Public Health Date: 2012-01-10 Impact factor: 2.702
Authors: Erica S Shenoy; Hang Lee; Jessica A Cotter; Winston Ware; Douglas Kelbaugh; Eric Weil; Rochelle P Walensky; David C Hooper Journal: Am J Infect Control Date: 2015-10-02 Impact factor: 2.918
Authors: Erica S Shenoy; Jiyeon Kim; Eric S Rosenberg; Jessica A Cotter; Hang Lee; Rochelle P Walensky; David C Hooper Journal: Clin Infect Dis Date: 2013-04-09 Impact factor: 9.079
Authors: Tanya Golubchik; Elizabeth M Batty; Ruth R Miller; Helen Farr; Bernadette C Young; Hanna Larner-Svensson; Rowena Fung; Heather Godwin; Kyle Knox; Antonina Votintseva; Richard G Everitt; Teresa Street; Madeleine Cule; Camilla L C Ip; Xavier Didelot; Timothy E A Peto; Rosalind M Harding; Daniel J Wilson; Derrick W Crook; Rory Bowden Journal: PLoS One Date: 2013-05-01 Impact factor: 3.240