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    Surveillance van meticillineresistente Staphylococcus aureus in Nederland in 1992 tot 1994

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    Authors
    van Leeuwen WJ
    Schot CS
    Rost JA
    de Neeling AJ
    van Klingeren B
    Type
    Report
    Language
    nl
    
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    Title
    Surveillance van meticillineresistente Staphylococcus aureus in Nederland in 1992 tot 1994
    Translated Title
    Surveillance of methicillin resistant Staphylococcus aureus in the Netherlands in 1992 to 1994
    Publiekssamenvatting
    De surveillance van meticilline resistente Staphylococcus aureus (MRSA) in Nederlandse ziekenhuizen is gestart in 1989. Gedurende de nu 6 jaar lopende studie zijn geen duidelijke verschuivingen in de aantallen MRSA waargenomen (ca. 200/jaar). De incidentie van MRSA bleef laag (< 1%). Verschillende keren heeft een MRSA aanleiding gegeven tot een secundaire verspreiding, maar in de meeste gevallen bleef een epidemie beperkt tot slechts enkele personen. Van 1992 - 1994 werd ca. 30% van de MRSA isolaten uit gerepatrieerde patienten in Nederlandse ziekenhuizen geintroduceerd ; 20% van alle MRSA isolaten was middels kruisbesmetting gerelateerd aan patienten afkomstig uit het buitenland en van 40% van de isolaten kon geen relatie met het buitenland worden vastgesteld. Faagtypering bleek een goede methode voor verdere differentiatie. Het merendeel van de isolaten was typeerbaar. Van de isolaten behoorde 45% tot een van de 5 epidemische typen. In de afgelopen 6 jaar is weinig verschuiving waargenomen in de resistentie percentages. De meeste isolaten waren multiresistent ; 80% was gevoelig voor cotrimoxazol. Er werd een toename van resistentie tegen fusidinezuur waargenomen (0% in 1989; 11% in 1994) en 8% van de isolaten was verminderd gevoelig voor mupirocine.<br>
    The surveillance study of methicillin-resistant Staphylococcus aureus (MRSA) in Dutch hospitals was started in 1989. During the 6 years period no clear changes in numbers of MRSA were observed (mean 200/year). The incidence of MRSA in Dutch hospitals is still low (< 1%). Several times a spread of MRSA occurred within a hospital but in most cases the epidemic was limited to only a few persons. In 1992 - 1994 about 30% of the MRSA was isolated from patients who had been admitted from foreign hospitals ; 20% of all MRSA-isolates were related to one of these "imported" MRSA and from 40% of the MRSA no foreign source could be detected. Phage typing is a powerful tool for typing MRSA. Most of the strains (96%) were typable ; 45% belonged to one of the 5 epidemic types found in the Netherlands. During the last 6 years no clear changes in antibiotic resistance was found. Most of the isolates were multi resistant ; 80% was sensitive to cotrimoxazole. There was an increase of resistance against fusidic acid (0% in 1989 ; 11% in 1994) and 8% of the isolates showed a decreased susceptibility to mupirocin.<br>
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
    Sponsors
    IGZ
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