28 Chapter 2 Results The questionnaire was completed by 114 Dutch GPs. The majority of the GPs (98/114, 86%) performed screening for MRSA carriership. Recent admission to a hospital abroad was more often considered to be the reason for screening in older patients with comorbidity (89/114, 78%) compared to younger patients without comorbidity (77/114, 68%). A previous infection with MRSA was considered to be a reason for screening by 55/114 (48%) of the GPs and a positive household contact by 39/114 (34%) of the GPs. The majority of the respondents, 98/114 (86%), reported having 1-3 new MRSA cases per year. Fifteen GPs (15/114, 13%) stated that they had never had a single patient in his/her practice. The median prevalence of MRSA carriers per practice was 2 (interquartile range 0–4). With regard to the familiarity with the explicit ‘search and destroy’ policy in the Netherlands, 98/114 (86%) of the GPs indicated that they were not familiar with this policy. Initiation of eradication therapy and/or referral for treatment Almost half of the GPs (52/114, 46%) estimated that <20% of the MRSA carriers in their practice received eradication therapy. With respect to the indication for eradication treatment, most of the GPs (58/114, 51%) stated that only specific MRSA carriers should be eligible for eradication treatment, namely if there is a specific reason (e.g., frequent hospital visits) (58/58, 100%), if the patient is a healthcare worker with clinical duties (52/58, 90%), if the patient has an infection with MSRA (42/58, 72%), or if the patient insists on treatment (10/58, 17%). The most important reasons to refrain from eradication therapy were: the potentially self-limiting nature of MRSA carriership (59%), unfamiliarity with the Dutch ‘search and destroy’ policy (25%), the burden of treatment for the patient (23%), the lack of any recommendation being known GP protocols (18%) and the patients’ explicit request not to be treated (18%) (Table 1).
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