Multidrug-resistant organisms and C-difficile in Munich acute-care clinics. Results from a point prevalence study of clinical routine data

To combat multidrug resistant organisms (MRDOs), networks have been established all over Germany. Here we show here how those networks can survey the prevalence of MRDOs and C. difficile (CD), as well as structure data (e.g. staffing with hygiene control personnel), with reasonable efforts. We conducted a questionnaire-based point prevalence survey in May 2012. The prevalence (colonisation or infection) of inpatient cases with methicillin-resistant S. aureus (MRSA), vancomycin resistant S. aureus (VRSA), vancomycin resistant E. faecalis/E. faecium (VR-E. faecalis/VR-E. faecium), extended-spectrum-beta-lactamase-producing E. coli (ESBL-EC) and K. pneumoniae (ESBL-KP), multiresistant Acinetobacter spp. (MAB), multiresistant Pseudomonas spp. (MRP), carbapenemase-producing Enterobacteriaceae (CRE) as well as infections with Clostridium difficile (CD) were assessed. Out of 45 hospitals asked to participate, 89 % sent back forms. Forms were filled out mostly by infection control personnel. In total 7154 patients were included. The most frequently reported MDROs were MRSA (prevalence: 1.37 % of all included patients), ESBL-EC (1.12 %), ESBL-KP (0.43 %) and VRE (0.38 %). VRSA and CRE were not reported. The prevalence of MRP (0.13 %) and MAB (0.03 %), was very low. The most frequently reported pathogen was CD (1.66 %). Point prevalence surveys are a feasible way to gain regional data on the epidemiology of MDROs and to raise local awareness. Staffing with infection control personnel remains an issue, given the prevalence of nosocomial pathogens.