PREVENTION AND CONTROL OF METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUSNOSOCOMIAL INFECTION IN BARCELONA (SPAIN)

Methicillin-resistant Staphylococcus aureus (MRSA) nosocomial infectio ns with multiply-resistant epidemic strains are an important infection control problem in hospitals in Barcelona, Spain. A prospective surve y, using a questionnaire mailed or fared to all public network hospita ls (n = 40) in Barcelona and the surrounding area, was used to evaluat e the prevalence of MRSA nosocomial infections and the use of control measures. The questionnaire inquired about demographic, microbiologica l and epidemiological data regarding MRSA nosocomial infections and wh at measures were used to control them. All 9 large hospitals (>500 bed s) and 15/31 smaller hospitals (<500 beds) answered the survey. (A sec ond random sample survey of non-respondent hospitals (n = 5) produced very similar results to those seen in the initial survey.) All large h ospitals reported outbreaks of MRSA nosocomial infections (average 8.0 +/- 5.9 new cases/month) with multiply-resistant strains. Only four o f the smaller hospitals reported MRSA infections (average 1.0 new case s/month). The main infection control procedures were active search for carriers (100%), special isolation wards (66%), nasal decolonization of health-care workers (88%, using mupirocin in 66% of cases), and sta ting of MRSA condition in the discharge report (100%). The control pro cedures currently recommended for MRSA infections are widely accepted and followed, but appear to be only partially successful in the long t erm.