Findings of a European Commission funded research project presented at today’s HPA conference show that levels of antibiotic use and infection control measures have a significant impact on MRSA levels in European hospitals.
The Antibiotic Resistance, Prevention And Control (ARPAC) project, which involved the Agency and Aberdeen Royal Infirmary, showed that out of approximately 300 European hospitals studied, those with the highest MRSA prevalence also had the greatest levels of antibiotic use. There was also strong evidence to prove that those hospitals which undertake specific infection control measures such as patient isolation are more likely to have a lower prevalence of MRSA. Out of the whole of Europe, ARPAC identified Southern and Western Europe as having the highest levels of MRSA.
Professor Barry Cookson, an MRSA expert at the Agency who took part in the project’s steering group said: “ARPAC investigated data from participating hospitals on antibiotic consumption, antibiotic resistance and also analysed hospital guidelines on antibiotic policies and infection control policies.
“In addition to the strong association between total antibiotic use and MRSA prevalence, the work also shows that the use of specific classes of antibiotics such as macrolides and third generation cephalosporins is also associated with higher MRSA prevalence.
“Low prevalence of MRSA was strongly linked with infection control procedures such as the isolation of patients with MRSA in single rooms; healthcare worker use of barrier precautions (for example gowns and gloves) to prevent cross contamination and the use of alcohol-based disinfectants by healthcare workers.
“This work has pinpointed effective policies covering antibiotic use and infection control policies on which ARPAC has based its recommended strategies for control and prevention of antibiotic resistance (including MRSA). The European Commission will be circulating these findings and strategies broadly to hospitals in Europe. They will also be made available on the web in the main European languages.”
Dr Fiona MacKenzie, Microbiologist at Aberdeen Royal Infirmary and Honorary Lecturer at the University of Aberdeen, who co-ordinated the project added, “The project uncovered some evidence that hospitals who screened their workers for MRSA had lower levels of carriage and infection. The importance of an alerting system reporting confirmed MRSA cases to infection control staff was highlighted by the work, as hospitals using such a system had lower MRSA prevalence. ARPAC also endorses the current minimum infection control staffing quotas and specialist training of infection control staff.”