Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is associated with increased mortality and morbidity and a leading cause of hospital-acquired infections. Community-acquired (CA)-MRSA are a growing concern worldwide. In the last 10 years, an increase in the MRSA rate from 2% to approximately 23% has been observed in Germany, while a rate under 5% has been recorded for many years in the Netherlands and Scandinavia. In the Netherlands in particular, MRSA rates have become very low in stationary care due to a consistent 'search and destroy' policy. The main focus in Germany lies on hospital-acquired MRSA, whereas the Netherlands focus on the control of the importation of MRSA cases from abroad and on CA-MRSA. As MRSA in hospitals and in the community can be a problem in cross-border health care, the European Union-funded EUREGIO MRSA-net project was established in the bordering regions Twente/Achterhoek, the Netherlands and Münsterland, Germany. The main aim of the project is the creation of a network of the major health care providers in the EUREGIO and the surveillance and prevention of MRSA infections. A spa-typing network was established in order to understand the regional and cross-border dissemination of epidemic and potentially highly virulent MRSA genotypes. As the reduction of differences in health care quality is an important prerequisite for cross-border health care, a transborder quality group comprising hospitals, general practitioners, public health authorities, laboratories, and insurerance companies has been established since 2005 equalising the quality criteria for the control of MRSA on both sides of the border.
Highlights
Staphylococcus aureus is responsible for the majority of healthcare-associated infections worldwide
The discussions showed that post-discharge case management of Methicillin-resistant Staphylococcus aureus (MRSA) patients was not done regularly on the German side
After 12 months of negative screening results was a patient to be considered MRSA-negative, Patients admitted to a hospital during that period need to be screened before admission or isolated until they are excluded as persistent carriers of MRSA
Summary
Staphylococcus aureus is responsible for the majority of healthcare-associated infections worldwide. It has been assumed that the rate of MRSA isolations from blood cultures in Germany has stabilised at a level around 20-30%, this is still significantly higher than in neighbouring countries such as The Netherlands and Denmark, where the rates have been around 1% for many years [1]. This is a clear signal that the MRSA rates in hospitals can be minimised by adopting a consistent and co-ordinated “search and destroy” approach [2]
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