Prevention and control of methicillin-resistant Staphylococcus aureus nosocomial infection in Barcelona (Spain)

Methicillin-resistant Staphylococcus aureus (MRSA) nosocomial infections with multiply-resistant epidemic strains are an important infection control problem in hospitals in Barcelona, Spain. A prospective survey, using a questionnaire mailed or fared to all public network hospitals (n = 40) in Barcelona and the surrounding area, was used to evaluate the prevalence of MRSA nosocomial infections and the use of control measures. The questionnaire inquired about demographic, microbiological and epidemiological data regarding MRSA nosocomial infections and what measures were used to control them. All 9 large hospitals (>500 beds) and 15/31 smaller hospitals (<500 beds) answered the survey. (A second random sample survey of non-respondent hospitals (n = 5) produced very similar results to those seen in the initial survey.) All large hospitals reported outbreaks of MRSA nosocomial infections (average 8.0 +/- 5.9 new cases/month) with multiply-resistant strains. Only four of the smaller hospitals reported MRSA infections (average 1.0 new cases/month). The main infection control procedures were active search for carriers (100%), special isolation wards (66%), nasal decolonization of health-care workers (88%, using mupirocin in 66% of cases), and stating of MRSA condition in the discharge report (100%). The control procedures currently recommended for MRSA infections are widely accepted and followed, but appear to be only partially successful in the long term.