[Significant decrease of rate and incidence of methicillin resistant Staphylococcus aureus in a French general hospital between 1999 and 2001].

Abstract

In our French general hospital of 1000 hospitalization beds, a specific isolation for multiresistant bacteria (MRB) colonized or infected patients was set up since 1998. To assess the impact of these recommendations, the rate and incidence of methicillin resistant Staphylococcus aureus (MRSA), the most important MRB recovered in French hospitals, were calculated for each year since 1999. All the strains isolated from clinical samples, except duplicates (same bacteria in the same patient), were included. The results were compared with the chi(2)-test. Between 1999 and 2001, 644 strains were isolated. MRSA rate went from 46% in 1999 to 41% in 2000, and to 37% in 2001 (P = 0.007). In the study proposed by the CCLIN Paris-Nord, in April, May and June of each year, the rate of SARM was 52% in 1999, 43% in 2000 then 36% in 2001. The incidence per 100 admissions was 0.73 in 1999, 0.59 in 2000 and 0.54 in 2001 (P = 0.002) and the incidence per 1000 hospitalization days was, respectively, 0.92, 0.74, 0.67 in 1999, 2000 and 2001 (P < 0.001). The significant decrease of the rate and incidence of SARM proved that the isolation policy was effective in our hospital. This decrease was obtained through cooperation between staff members, bacteriologists and hospital nosocomial infection committee members. We know that measures to prevent MRSA cross transmission are very difficult to maintain over a long time and we hope that indicators would not increase next year. The use of alcohol based hand-rub since May 2002 should contribute to maintain this decrease.