Annette Westgeest

67 Effectiveness of MRSA decolonization regimens 4 Data collection The electronic patient files were reviewed to record patient characteristics, clinical data relevant for MRSA decolonization (e.g., immune status and skin diseases), environmental factors (e.g., health care profession, household members) and microbiological data (culture results and antimicrobial susceptibility patterns). In each hospital, the prescribed antibiotic therapy and treatment duration for all treatment episodes were extracted from the hospital electronic prescribing system. Microbiological data were retrieved from the Department of Medical Microbiology of each hospital. Definitions Uncomplicated MRSA carriership was defined as the presence of MRSA exclusively located in the nose and no active infection with MRSA and in vitro sensitivity for mupirocin and the absence of active skin lesions and the absence of foreign material that connects an internal body site with the outside (e.g., urine catheter, external fixation material) and no previously failure of decolonization treatment. All other situations were considered complicated colonization [12]. An ‘isolated patient’ was defined as a solitude carrier without any known family or household members with MRSA colonization. In case of any known positive family or household member, these patients together were considered a cluster. A household member was defined as a person sharing the same house by day and night and sharing a bedroom and/or bathroom, and/or living room and/or kitchen [12]. Immunocompromised status was defined as either a hematologic malignancy, stem cell transplantation, organ transplantation, immunosuppressive medication (e.g., chemotherapy, steroids) or HIV infection. The primary outcome of the study was success rate of decolonization treatment, defined by three times negative MRSA cultures from swabs taken from nose, throat and perineum. The first culture needed to be taken at least 48 hours after treatment, with the follow-up cultures obtained with one-week intervals. The long-term success rate was defined as an additional set of negative MRSA swabs one year after decolonization treatment (data available for four hospitals). Statistical analysis and outcome Data were presented as rates (percentages or proportions) for categorical variables and as medians plus interquartile range (IQR) for continuous variables. The overall success rate of decolonization treatment was presented as a rate, with 95% confidence interval (95%CI), and was stratified for different treatment strategies.

RkJQdWJsaXNoZXIy MTk4NDMw