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Report from the MRSA Working Group

Report from the MRSA Working Group. Background. 20 th SSAC in Odense Presentation by Prof. Karl G. Kristinsson documented an increasing incidence of MRSA in the Nordic countries SSAC MRSA Working Party formed. Goal.

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Report from the MRSA Working Group

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  1. Report from the MRSA Working Group

  2. Background • 20th SSAC in Odense • Presentation by Prof. Karl G. Kristinsson documented an increasing incidence of MRSA in the Nordic countries • SSAC MRSA Working Party formed

  3. Goal • Keeping the level of methicillin resistance in Staphylococcus aureus below 1% in the Nordic Countries

  4. Denmark: • Dr. Hans Jørgen Kolmos, Odense University Hospital • Dr. Robert Skov, SSI, Chair Finland: • Dr. Reijo Peltonen, Turku University Hospital • Dr. Jaana Vuopio-Varkila, KTL Iceland: • Dr. Hjordis Hardardottir, Landspitali University Hospital • Dr. Olafur Gudlaugsson, Landspitali University Hospital Norway: • Dr. Stig Harthug, Haukeland University Hospital, and Norsk Folkehelse • Dr. Yngvar Tveten, Telelab Sweden: • Dr. Barbro Olsson-Liljequist, SMI • Dr. Tinna Åhrén, Sahlgrenska University Hospital

  5. Tasks 1 • Suggest simple ways on • how national data on the epidemiology of MRSA can be reported to the Working Party • reporting of the information to different stakeholders and the public domain • Compare current guidelines and practices, including registration practices, laboratory methodology and infection control in the Nordic countries and identify similarities and major discrepancies.

  6. Tasks 2 • Suggest quantifiable (measurable) goals for the preventive strategies against MRSA in the Nordic countries. • Suggest measures to obtain these goals • Identify and prioritise areas where there are important gaps of knowledge and suggest studies in these areas • Report regularly to the SSAC board and at SSAC meetings.

  7. Focus areas • Epidemiology • Laboratory Methodology • Infection Control

  8. Epidemiology • Currently the terms and definitions vary between the Nordic countries. • Reporting infections vs both infections and carriers • Definition of a new episode vs relapse • Acquisition • HA-MRSA • CO-MRSA • CA-MRSA

  9. Denmark

  10. Denmark - acquisition - 2003

  11. Finland, 1.1.1995-31.7.2004 Source: KTL, National Infectious Disease Register

  12. Finland; children and the elderly Source: KTL, National Infectious Disease Register

  13. Iceland

  14. Sweden

  15. Sweden

  16. Epidemiology • Suggestions for the future • Development of uniform terms and definitions • Initiate a coordinated Nordic surveillance project

  17. Laboratory methods • All countries but Norway have one central laboratory for MRSA surveillance • Norway is expected to have one quite soon • Collaboration on optimizing detection of MRSA • Collaboration on uniform strain nomenclature

  18. Infection Control • It is possible to care for MRSA positive patients without spread of MRSA. • For the successful control of MRSA it is imperative that the MRSA positive patient have the same rights for and access to medical care as the MRSA negative patient.

  19. Infection Control • It has been observed that the increase is slower in areas which practice very strict MRSA policy • For control of MRSA in hospitals it is imperative to convince medical staff and administrators that hygiene precautions must be incorporated into daily routines

  20. Infection Control • In order to enhance compliance and decrease the risk for confusion, identical measures should be applied within all institutions within the same area/region. • These measures should be in accordance with national guidelines and regulations.

  21. Infection Control • Suggestions for the future • Perform a Nordic multicenter study in community onset MRSA

  22. Conclusion 1 • The information collected and shared in the Working Party has been of great importance for use in the debate and decision making in the individual countries.

  23. Conclusion 2 • What is needed now • Development of uniform epidemiological terms and definitions • Priority 1 • Increased knowledge on CA-MRSA • Establish rapid exchange of information of epidemics and endemicity between the Nordic countries.

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