38 Chapter 2 o Patients who still need to pay their own risk (health insurance) o Other 11. What are reasons for you to refrain from referral of patients with MRSA carriership? (Multiple answers possible) I did not know of the existence of MRSA outpatient clinics It is not recommended in the GP protocol to refer patients for eradication I feel competent in performing the treatment myself Patients do not wish to be referred The costs for the patient The administrative burden that comes with a referral Other: ….……………………………………………… 12. Are you familiar with the ‘search and destroy’ policy with regards to MRSA? This ‘search and destroy’ policy means patients with high risk of MRSA colonization need to be screened and that we aim at eradication treatment of MRSA carriers. Yes / No Now we want to present two cases. 13. Case A: A 26 years-old healthy male was admitted in the hospital during a holiday in Spain because of a trauma. After returning in the Netherlands, you perform culture swabs from nose, throat and perineum. The nasal culture is positive for MRSA. There are no skin lesions. There are no hospital visits planned. What do you recommend with regards to the MRSA carriership? No eradication treatment I treat the MRSA carriership myself I refer the patient to the outpatient clinic Other: …………………………………………… In case of treatment yourself, which treatment do you prescribe? Mupirocin nose cream + disinfecting soap + hygienic measures The above in combination with systemic antibiotics Other: …………………………………………… 14. Case B: A 56 years-old male with a history of heart failure and chronic kidney disease, was screened for MRSA carriership by you following a hospital admission. He is MRSA positive in nose, throat and perineum. What do you recommend with regards to the MRSA carriership? No eradication treatment I treat the MRSA carriership myself I refer the patient to the outpatient clinic Other: …………………………………………………
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