Re: New Study Sheds New Light On Pig Farms And MRSA Bacteria Transmission
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Surveillance report
Dutch measures to control MRSA and the expanding European Union
volume 5 issue 3 publication date March 2000 page 26-28 PDF
JHT Wagenvoort
Department of Medical Microbiology, Regional Public Health Laboratory, Heerlen, The Netherlands
The Dutch national policy for the prevention of spread of methicillin resistant Staphylococcus aureus (MRSA) has shown that
it is possible to suppress and prevent MRSA from becoming endemic in hospitals.
Implementation of effective measures against MRSA will also help prevent the spread of other infections in hospitals.
The problem of MRSA would benefit from a common European Union policy.
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Methods
How have Dutch hospitals brought MRSA under control? Over ten years ago the Working Party for Infection Prevention produced guidelines for the containment of MRSA (4), which have been endorsed by the Health Inspectorate.
The mainstay of the guidelines is a ‘search and destroy’ strategy.
- All patients with MRSA are isolated in private rooms.
- Patients from foreign hospitals and suspected MRSA carriers (
including pig farmers,ed) are screened and isolated.
- Contact patients and also health care workers are screened.
- MRSA positive contacts are treated with body washings with either 4% chlorhexidine liquid soap or 7.5% polividone–iodine shampoo and mupirocin nose ointment, which may lower the bacterial load and therewith the degree of spread. (Healthy people who are usually MRSA positive, presumably most health care workers, are usually decontaminated with such treatment applied for five days.)
- Small numbers of MRSA can be identified by taking samples twice within 24 hours of nose, throat, sputum, perineum, urine, skin lesions, and wounds, and culturing using enrichment broth (5).
- The movement of MRSA carriers between hospitals generates a warning.
The policy is for such patients to be readmitted to the same hospital as far as possible. The efforts of infection control practitioners and clinical microbiologists are vital.
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Another backbone in the prevention of resistant bacteria is the implementation of
a strict antibiotic policy in Dutch hospitals. This is steered by local committees and many hospitals produce their own formularies with lists of ‘first choice’ compounds and their indications for use.
Rates of resistance of clinically important bacteria are low (8) and older antibiotics continue to be first line drugs in the treatment of serious infections, including those on intensive care units.
more:
http://www.eurosurveillance.org/em/v05n03/0503-222.asp