Methicillin-resistant Staphylococcus aureus in French hospitals: A 2-monthsurvey in 43 hospitals, 1995

OBJECTIVE: To estimate the incidence of methicillin-resistant Staphylococcu s aureus (MRSA) in patients hospitalized in French public hospitals. DESIGN: A 2-month survey that included 163,573 patients and 140,114 admissi ons. SETTING AND PATIENTS: Forty-three public or public-affiliated hospitals thr oughout France, including 12 university-affiliated hospitals. Information w as recorded on all patients having MRSA recovered from culture of any clini cal sample. RESULTS: The overall median incidence rate (per 1,000 admissions) of clinic ally detected MRSA was 5.9 (range, 1.8-15.8); median rates were similar in hospitals affiliated or not affiliated to universities (6.4 and 5.9, respec tively). Smaller unaffiliated hospitals (<500 beds) had higher MRSA inciden ce rates (mean, 7.2) than larger (>500 beds) unaffiliated hospitals or univ ersity hospitals (mean, 6.7 and 6.1, respectively). The incidence density ( per 1,000 patient-days) of MRSA was higher in intensive-care units [ICUs] 2 .39/1,000) than in surgical (0.80/1,000) and medical (0.70/1,000) wards, re spectively; comparable rates were recorded in rehabilitation units (0.67/1, 000), whereas in long-term-stay units, the incidence density of MRSA was 0. 27/1,000 patient-days. Of 958 MRSA isolates, 660 (69%) also were resistant to all aminoglycosides. In 411 (43%) of 958 patients, the MRSA isolate was considered imported (ie, first recovered within 72 hours of the patient's a dmission to the unit). More than one half (53%) of imported cases were tran sfer patients from other hospitals, and 17% originated from ICUs. CONCLUSION: MRSA is extensive in French hospitals. All categories of hospit als are involved to a similar extent, and there is intense circulation of p atients colonized or infected with MRSA between units and hospitals. Contai nment of MRSA would mandate increasing resources devoted to infection contr ol, especially in smaller hospitals, and control programs should involve no tification of carriers and screening of patients at risk of MRSA carriage o n admission to detect carriers and to implement isolation precautions rapid ly.