Het Nederlandse MRSA-beleid kan en moet anders

The Dutch MRSA policy can and should be different

The methicillin-resistant Staphylococcus aureus (MRSA) infection rate in the Netherlands is low thanks to a nationwide ‘search and destroy’ MRSA policy. This policy is based on two factors: MRSA in the community was rare and all patients at risk for MRSA are isolated until culture results are negative. However, in 2005, livestock-associated MRSA emerged. This gave rise to an MRSA reservoir in the community. Yet the risk of livestock-associated MRSA being transmitted is low compared to that of other MRSA strains. Moreover, MRSA prevalence is lower in patients treated in a foreign hospital than had been assumed in the past. New tests (chromogenic media and PCR) have become available that allow rapid detection of MRSA carriage, resulting in a 48-60% decrease in isolation days. When rapid tests are performed, in addition to conventional cultures, patients at risk no longer need to be isolated and the closure of wards due to the risk of an outbreak is no longer necessary.

Conflict of interest: prof.dr.M.J.M.Bonten is financially supported by the Netherlands Organisation for Scientific Research (NWO) (NWO-VICI 918.76.611); he gave lectures for Pfizer and Cepheid and advised Ipsat therapies, 3M, Cepheid, Novartis and Bayer. Financial support for the studies mentioned: the studies into the rapid tests for MRSA were in part financed by the Netherlands Organisation for Health Research and Development ZonMw (nr 945-05-041), GeneOhm Sciences Inc., België (presently Becton Dickinson), bioMérieux, France and Cepheid Europe, France.