Control and the prevention of methicillin-resistant Staphylococcus aureus in hospitals in Ireland:: North/South Study of MRSA in Ireland 1999

As part of an all-island survey of methicillin-resistant Staphylococcus aureus (MRSA) in the Republic of Ireland (the South), where there is a mixed public and private healthcare system, and Northern Ireland (the North), where the healthcare system is part of the UK National Health Service, a questionnaire was circulated to all participating hospitals on measures routinely taken to control MRSA. Response rates were 100% in the North and 89% in the South. Over 70% of hospitals screened particular groups of patients on admission to hospital. Ninety-five percent of hospitals in the North and 88% in the South attempted to eradicate MRSA from carriage sites. Most hospitals attempted to isolate or cohort positive patients. About a quarter of hospitals in both parts of Ireland screened new healthcare workers for the presence of MRSA. Terminal decontamination of the environment after the discharge of a patient positive for MRSA was the norm in over 90% of hospitals, however, 6% of hospitals in the South used inappropriate disinfectants for MRSA. All hospitals in the North, but a minority (41%) in the South, had written antibiotic prescribing policies, but only 65% of hospitals in the South had access to an infection control committee, acute hospitals having greater access than district hospitals. The prevention and control of spread of MRSA remains a major challenge in the North and in the South. Although most hospitals in the North and in the South implemented current recommended guidelines on the control of MRSA in hospitals, there was some variability that may be resource related. Policies need to be reviewed in the light of the changing epidemiology of MRSA. (C) 2003 The Hospital Infection Society.