Antimicrobial drug use and infection control practices associated with the prevalence of methicillin-resistant Staphylococcus aureus in European hospitals

Fiona MacKenzie, Julie Bruce, M. J. Struelens, H. Goossens, Jill Ann Mollison, Ian M Gould, ARPAC Steering Group

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Major regional variations in the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) are observed across Europe. This study investigated hospital MRSA prevalence in relation to patterns of antimicrobial use and infection control policies in an observational, cross-sectional study that used retrospective data from 2001 and linear regression to model relationships. MRSA prevalence (median 20.8%, n = 173 hospitals) and antimicrobial consumption (median 55.2 defined daily doses/100 bed-days, n = 140 hospitals) both varied significantly according to geographical region (p < 0.001). MRSA prevalence and antimicrobial consumption data were provided by 128 hospitals, and showed a strong statistical relationship between macrolide use and MRSA prevalence. Use of (i) third-generation cephalosporins, (ii) all antimicrobial agents, and (iii) all antimicrobial agents except glycopeptides was also associated with MRSA prevalence. Up to 146 hospitals provided data on MRSA prevalence and key infection control parameters. Adjusted linear regression modelling provided strong evidence that infection control policy recommendations associated with lower MRSA prevalence rates were (i) use of alcohol-based solutions for hand hygiene (mean difference 10.3%, 99% CI 1.2-10.3), and (ii) placement of MRSA patients in single rooms (mean difference 11.2%, 99% CI 1.4-20.9). Hospitals with problems in implementing isolation policies had higher resistance levels (mean difference 12%, 99% CI 3.8-20.1). Additional recommendations showed less evidence of association with a low MRSA prevalence. Overall, this study highlighted significant associations between MRSA prevalence, antimicrobial use and various key infection control parameters, all of which showed significant individual variations according to geographical region.

Original languageEnglish
Pages (from-to)269-276
Number of pages8
JournalClinical Microbiology and Infection
Volume13
Issue number3
Early online date1 Nov 2006
DOIs
Publication statusPublished - Mar 2007

Keywords

  • antimicrobial use
  • ARPAC
  • European hospitals
  • infection control policies
  • nosocomial infection
  • MRSA prevalence
  • pathogens
  • carriage
  • spread
  • models
  • risk

Cite this

Antimicrobial drug use and infection control practices associated with the prevalence of methicillin-resistant Staphylococcus aureus in European hospitals. / MacKenzie, Fiona; Bruce, Julie; Struelens, M. J.; Goossens, H.; Mollison, Jill Ann; Gould, Ian M; ARPAC Steering Group.

In: Clinical Microbiology and Infection, Vol. 13, No. 3, 03.2007, p. 269-276.

Research output: Contribution to journalArticle

MacKenzie, Fiona ; Bruce, Julie ; Struelens, M. J. ; Goossens, H. ; Mollison, Jill Ann ; Gould, Ian M ; ARPAC Steering Group. / Antimicrobial drug use and infection control practices associated with the prevalence of methicillin-resistant Staphylococcus aureus in European hospitals. In: Clinical Microbiology and Infection. 2007 ; Vol. 13, No. 3. pp. 269-276.
@article{abdd5658e29e4533ad6da59ae711b31e,
title = "Antimicrobial drug use and infection control practices associated with the prevalence of methicillin-resistant Staphylococcus aureus in European hospitals",
abstract = "Major regional variations in the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) are observed across Europe. This study investigated hospital MRSA prevalence in relation to patterns of antimicrobial use and infection control policies in an observational, cross-sectional study that used retrospective data from 2001 and linear regression to model relationships. MRSA prevalence (median 20.8{\%}, n = 173 hospitals) and antimicrobial consumption (median 55.2 defined daily doses/100 bed-days, n = 140 hospitals) both varied significantly according to geographical region (p < 0.001). MRSA prevalence and antimicrobial consumption data were provided by 128 hospitals, and showed a strong statistical relationship between macrolide use and MRSA prevalence. Use of (i) third-generation cephalosporins, (ii) all antimicrobial agents, and (iii) all antimicrobial agents except glycopeptides was also associated with MRSA prevalence. Up to 146 hospitals provided data on MRSA prevalence and key infection control parameters. Adjusted linear regression modelling provided strong evidence that infection control policy recommendations associated with lower MRSA prevalence rates were (i) use of alcohol-based solutions for hand hygiene (mean difference 10.3{\%}, 99{\%} CI 1.2-10.3), and (ii) placement of MRSA patients in single rooms (mean difference 11.2{\%}, 99{\%} CI 1.4-20.9). Hospitals with problems in implementing isolation policies had higher resistance levels (mean difference 12{\%}, 99{\%} CI 3.8-20.1). Additional recommendations showed less evidence of association with a low MRSA prevalence. Overall, this study highlighted significant associations between MRSA prevalence, antimicrobial use and various key infection control parameters, all of which showed significant individual variations according to geographical region.",
keywords = "antimicrobial use, ARPAC, European hospitals, infection control policies, nosocomial infection, MRSA prevalence, pathogens, carriage, spread, models, risk",
author = "Fiona MacKenzie and Julie Bruce and Struelens, {M. J.} and H. Goossens and Mollison, {Jill Ann} and Gould, {Ian M} and {ARPAC Steering Group}",
year = "2007",
month = "3",
doi = "10.1111/j.1469-0691.2006.01592.x",
language = "English",
volume = "13",
pages = "269--276",
journal = "Clinical Microbiology and Infection",
issn = "1198-743X",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - Antimicrobial drug use and infection control practices associated with the prevalence of methicillin-resistant Staphylococcus aureus in European hospitals

AU - MacKenzie, Fiona

AU - Bruce, Julie

AU - Struelens, M. J.

AU - Goossens, H.

AU - Mollison, Jill Ann

AU - Gould, Ian M

AU - ARPAC Steering Group

PY - 2007/3

Y1 - 2007/3

N2 - Major regional variations in the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) are observed across Europe. This study investigated hospital MRSA prevalence in relation to patterns of antimicrobial use and infection control policies in an observational, cross-sectional study that used retrospective data from 2001 and linear regression to model relationships. MRSA prevalence (median 20.8%, n = 173 hospitals) and antimicrobial consumption (median 55.2 defined daily doses/100 bed-days, n = 140 hospitals) both varied significantly according to geographical region (p < 0.001). MRSA prevalence and antimicrobial consumption data were provided by 128 hospitals, and showed a strong statistical relationship between macrolide use and MRSA prevalence. Use of (i) third-generation cephalosporins, (ii) all antimicrobial agents, and (iii) all antimicrobial agents except glycopeptides was also associated with MRSA prevalence. Up to 146 hospitals provided data on MRSA prevalence and key infection control parameters. Adjusted linear regression modelling provided strong evidence that infection control policy recommendations associated with lower MRSA prevalence rates were (i) use of alcohol-based solutions for hand hygiene (mean difference 10.3%, 99% CI 1.2-10.3), and (ii) placement of MRSA patients in single rooms (mean difference 11.2%, 99% CI 1.4-20.9). Hospitals with problems in implementing isolation policies had higher resistance levels (mean difference 12%, 99% CI 3.8-20.1). Additional recommendations showed less evidence of association with a low MRSA prevalence. Overall, this study highlighted significant associations between MRSA prevalence, antimicrobial use and various key infection control parameters, all of which showed significant individual variations according to geographical region.

AB - Major regional variations in the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) are observed across Europe. This study investigated hospital MRSA prevalence in relation to patterns of antimicrobial use and infection control policies in an observational, cross-sectional study that used retrospective data from 2001 and linear regression to model relationships. MRSA prevalence (median 20.8%, n = 173 hospitals) and antimicrobial consumption (median 55.2 defined daily doses/100 bed-days, n = 140 hospitals) both varied significantly according to geographical region (p < 0.001). MRSA prevalence and antimicrobial consumption data were provided by 128 hospitals, and showed a strong statistical relationship between macrolide use and MRSA prevalence. Use of (i) third-generation cephalosporins, (ii) all antimicrobial agents, and (iii) all antimicrobial agents except glycopeptides was also associated with MRSA prevalence. Up to 146 hospitals provided data on MRSA prevalence and key infection control parameters. Adjusted linear regression modelling provided strong evidence that infection control policy recommendations associated with lower MRSA prevalence rates were (i) use of alcohol-based solutions for hand hygiene (mean difference 10.3%, 99% CI 1.2-10.3), and (ii) placement of MRSA patients in single rooms (mean difference 11.2%, 99% CI 1.4-20.9). Hospitals with problems in implementing isolation policies had higher resistance levels (mean difference 12%, 99% CI 3.8-20.1). Additional recommendations showed less evidence of association with a low MRSA prevalence. Overall, this study highlighted significant associations between MRSA prevalence, antimicrobial use and various key infection control parameters, all of which showed significant individual variations according to geographical region.

KW - antimicrobial use

KW - ARPAC

KW - European hospitals

KW - infection control policies

KW - nosocomial infection

KW - MRSA prevalence

KW - pathogens

KW - carriage

KW - spread

KW - models

KW - risk

U2 - 10.1111/j.1469-0691.2006.01592.x

DO - 10.1111/j.1469-0691.2006.01592.x

M3 - Article

VL - 13

SP - 269

EP - 276

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

SN - 1198-743X

IS - 3

ER -