Table 3

MRSA prevalence among patients in clinical settings

NO.

Author, First

Study design

Screening policy

Results

Comments

Quality rating4

Country, Year of Publication

Study period (no. of months)

Study setting1 (no. of units) (n)

Study population

Basic no. of cases potentially eligible/no. of participants (n)

Screening methods

(Origin of specimen)

Swabbing

sites

No. of MRSA patients colonised (C) or infected (I) or no. of isolates (n)

Prevalence of MRSA

% MRSA among patients

Mean2 (95% CI) Range3

% MRSA among S.aureus isolates Mean2

Density (no. of MRSA per 1,000 patients days


12

Chaberny

[46]

Germany

2008

2005 (<1)

ICU (1), surgery (1), neurology (1), internal medicine (1)

Patients

700/509

On a given study day

Nares, throat, skin lesions

27 (C)

5.3 (3.5-7.7)

ICU: 11.5a Surgery: 5.5a Neuro. 11.8 Int. med.: 5.1

19.0

a Units with established admission screening

Good

1Y; 2Y; 3Y; 4Y; 5Y; 6Y; 7Y

13

Chaberny [47]

Germany

2005

2002

(12)

ICU (4)

Admissions

?/188.615

On admission of patients at risk for MRSA

Clinical samples5

n.r.

505 (C) 404 (I)

0.48

0.64a

0.29a,b

a Admissions

b Noso-comial

Fair

1Y; 2Y; 3N; 4Y; 5N; 6Y; 7?

14

Chaberny

[7]

Germany

2007

2004 (12)

Hospital (31)

Hospita-lized patients

?/660.042

During hospital stay

Clinical samples5

Nares

2.786 (C) 1.429 (I)

0.71a

0.27a,b

a Admissions

b Noso-comial

Fair

1Y; 2Y; 3Y; 4N; 5Y; 6N; 7N

15

Eveillard

[48]

France

2002

2000 (1)

Acute geriatric ward (2)

Patients

244/239

On the first day of admission

Nares, wounds

35 (C)

14.6 (10.1-19.1)

Fair

1N; 2Y; 3Y; 4Y; 5N; 6N; 7N

16

Anonymous

[49]

Germany

2010

2008 (1)

RC (6), GH (8)

Patients

?/6.985

On admission during initial exa-mination

Nose,

throat

95 (C)

RC: 2.1

GH: 1.2

RC: 9.4

GH: 5.5

Fair

1N; 2Y; 3Y; 4N; 5N; 6?; 7Y

17

Hassan

[50]

Ireland

2008

2005 (3)

Orthopedic ward (2)

Patients

690/686

Within 24 hrs of admission

Nose, perineum, surgical wounds

27 (C)

3.9

Fair

1N; 2N; 3Y; 4Y; 5N; 6Y; 7N

18

Hori

[14]

UK

2002

2000 (4)

UH (1)

Patients older than 64 years

431/342

On the 21st day after admission

Nares

54 (C)

15.8

Fair

1N; 2Y; 3Y; 4Y; 5Y; 6N; 7N

19/1

Kappstein

[51]

Germany

2009

2000-2005 (72)

UH (1)

Patients

?

On admission

Clinical samples5

Nose

489 (C) 38 (I)

0.42

Poor

1Y; 2N; 3N; 4N; 5N; 6N; 7N

19/2

Kappstein

[51]

Germany

2009

2002-2005 (42)

UH (1)

Patients

141.249/29.692

Within

48 hrs of admission

Nose, wounds

231 (C)

0.78

20

Kresken

[26]

Germany

2009

2007

(1)

LF (26)

S. aureus isolates

?/872

Clinical samples5

159 isolates

20.3

Poor

1N; 2Y; 3Y; 4N; 5N; 6N; 7N

21

Lucet

[52]

France

2009

2003-2004

(14)

Hospitals for primary and tertiary care (16)

Patients at discharge to home care, > 48 hrs in hospitala

2.025/1.501

Within

3 days before discharge

Nose, chronic skin lesions

191 (C)

12.7

(11.0-14.5)

a Obstetric patients excluded

Fair

1Y; 2N; 3Y; 4Y; 5Y; 6Y; 7N

22

Lucet

[53]

France

2005

2002

(3,5)

Acute care ward in a hospital (1)

Patients older than 75 years, > 24 hrs in hospital

1.434/797

Within 48 hrs of admission

Nose,

skin breaks

63 (C)

7.9a

(6.0-9.8)

29.7a

a Admissions

Fair

1Y; 2N; 3Y; 4Y; 5Y; 6Y; 7N

23

Meyer

[54]

Germany

2006

2001-2004

(48)

ICU (40)

S. aureus isolates of patients with noso-comial infections

?/12.238

Clinical samples5

2.631 isolates

21.5

4.4

Good

1Y; 2Y; 3Y; 4Y; Y5; 6N; 7N

24

Morange-Saussier

[55]

France

2006

2004

(4)

Vascular surgery (1)

Patients,

> 24 hrs in hospital

?/308

On admission and 1 wk thereafter

Nares

13 (C)

4.2

27.0

Fair

1Y; 2Y; 3Y; 4Y; 5N; 6N; 7N

25

Gopal Rao

[29]

UK

2007

2004-

2005

(12)

GH (1); emergency department

Adult emergency admissions

13.826/7.801

Prior to admission

Nose,

axillae

670 (C)

433 (C)

8.6a

6.7b

a Admissions

b Patients

Fair

1N; 2Y; 3Y; 4Y; 5Y; 6N; 7N

26

Reilly

[56]

UK

2010

2008

(5)

GH (6)

Emergency (68%) and elective (32%) admissions

29.690/26.160

On admission or at pre-admission (7.5%)

Nose, wounds, invasive device sites

988 (C+I)

3.8a

(3.5-4.0)

a Admissions

Fair

1N; 2N; 3Y; 4Y; 5Y; 6Y; 7N

27

Tai

[57]

UK

2004

2000

(12)

Orthopedic and trauma surgery (1)

Patients

at high risk for MRSA

1.879/121

On admission

Clinical samples5

Nose, throat, axillae,

groins,

wounds

10 (C)

21 (I)

1.6

Poor

1Y; 2N; 3Y; 4N; 5N; 6N; 7N

28

Thompson

[58]

UK

2004

2001-2004

(30)

ICU (1)

Admissions to ICU

1.472/1.361

On admission Weekly screening cycle

Clinical samples5

Nose, groins

119 (C+I)

68 (C+I)b

8.7a (6.1-10.2)

a Admissions

b Nosocomial

Incidence:

1st wk: 7.5%; 2nd to 4th wk: 20.3%

Fair

1Y; 2?; 3Y; 4?; 5Y; 6N; 7N

29

Tiemersma

[3]

Germany

2004

1999-2002

(36)

Hospitals (25)

S. aureus blood isolates

?/3.757

Blood cultures5

600 isolates

13.8

Poor

1Y; 2?; 3N; 4Y; 5N; 6N; 7N

30

Vos

[59]

NL

2009

2000-2004

(60)

UH (1)

Admissions

at high risk for MRSA

?/

21.598

On admission

Nose, throat, perineum, invasive devices, wounds

123 (C)

0.10

0.0028a

a Related to bacteremia cases

Fair

1N; 2Y; 3Y; 4N; 5Y; 6N; 7Y

31

Walley

[60]

UK

2009

2003

(3)

Trauma and ortho-pedic ward (1)

Elective and trauma patients,

> 48 hrs in hospital

559/323

Within 24-48 hrs of admission

Nose, perineum

78 (C)

24.0

Fair

1Y; 2N; 3Y; 4Y; 5Y; 6?; 7N

11/2

Woltering

[45]

Germany

2008

GH (5),

RC (3)

Patients

1.321/818

On

a 2-days screening period in each unit

Nose, throat, wounds

GH: 17 (C)

RC: 6 (C)

GH: 3.4

(2.1-5.6)

RC: 1.2

(0.4-3.3)

GH: 11.6

RC: 5.6

Good

1N; 2Y; 3Y; 4Y; 5Y; 6N; 7Y


1: UH = University hospital, ICU = Intensive care unit, TH = Teaching hospital, GH = General hospital, RC = Rehabilitation centre, LF = Laboratory facility, n.r. = not reported.

2: Pooled mean calculated as a combined prevalence rate over all units with 95% CI.

3: Range within the individual units.

4: Levels for study quality: Good (= 6 and 7 points), fair (= 3 - 5 points), poor (= 1 and 2 points). Numbers belong to the questions as illustrated in Table 1.

5: Specimens (blood, sputum, others) taken for diagnostic purposes. Abbreviations: CI, Confidence intervals; hrs, hours; N, no; wk, week; Y, Yes; ?, unclear or missing information.

Dulon et al. BMC Infectious Diseases 2011 11:138   doi:10.1186/1471-2334-11-138

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