A survey of methicillin-resistant Staphylococcus aureus control strategies in Italy

• Published in: Infection Vol. 41; no. 4; pp. 783 - 789
• Main Authors: Pan, A., Bombana, E., Tura, G., Curti, C., Lorenzotti, S., Mondello, P., Patroni, A., Tacconelli, E., Rigobello, V., Signorini, L., Vizio, M., Goglio, A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2013; Springer Nature B.V
• Subjects: Clinical and Epidemiological Study; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - prevention & control; Decolonization; Education; Family Medicine; General Practice; Guideline Adherence - statistics & numerical data; Health Services Research; Hospitals; Humans; Infection Control - methods; Infectious Diseases; Internal Medicine; Italy - epidemiology; Medicine; Medicine & Public Health; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Multivariate analysis; Public health; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal Infections - prevention & control; Staphylococcus aureus; Surveys and Questionnaires; Italy; Italy; Control; Survey; Methicillin-resistant
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-013-0454-7

Purpose Data regarding the implementation of state-of-the-art methicillin-resistant Staphylococcus aureus (MRSA) control procedures in Italy are lacking. There is a need to evaluate compliance with MRSA recommendations (CR) in Italian hospitals. Methods A 67-question closed-answer survey was sent to all Italian hospitals, in order to analyze and evaluate program consistency with CR [hand hygiene (HH), contact precautions, screening of high-risk patients, decolonization, feedback on surveillance data, and antimicrobial guidelines and education programs]. Results 205 hospitals, which account for 42 % of national admissions, returned questionnaires. 131 hospitals (64 %) did not have written MRSA control guidelines. Hospitals reported the following levels of compliance with CR: (1) HH: 67 hospitals (33 %); (2) contact precautions: 33 (16 %); (3) MRSA screening: 66 (32 %); (4) MRSA decolonization: 42 (20 %); (5) surveillance data feedback: 87 (43 %); and (6) antimicrobial guidelines and education programs: 41 (20 %). One hospital (0.5 % of responses) had implemented all recommendations and 28 hospitals (14 %) had implemented four or five recommendations. 31 % of hospitals surveyed had implemented none. Multivariate analysis showed that the only factor identified as being associated with the implementation of MRSA control recommendations was the number of meetings/year of the infection control team (ICT) ( p  = 0.004). Conclusions Written MRSA control guidelines are available in only one-third of Italian facilities. An organized system, with ≥4 interventions, has been implemented in just 1 out of 7 hospitals. HH programs and ICT activity are related to better MRSA control. In Italy, there is significant opportunity for improvement in MRSA control.