• Heidi S M Ammerlaan, Jan A J W Kluytmans, Hanneke Berkhout, Anton Buiting, Els I G B de Brauwer, Peterhans J van den Broek, Paula van Gelderen, Sander A C A P Leenders, Alewijn Ott, Clemens Richter, Lodewijk Spanjaard, SpijkermanIngrid J BIJ, Frank H van Tiel, G Paul Voorn, Mireille W H Wulf, Jan van Zeijl, Annet Troelstra, Marc J M Bonten, and MRSA Eradication Study Group.
• Department of Medical Microbiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. h.ammerlaan@umcutrecht.nl
• J. Antimicrob. Chemother. 2011 Oct 1; 66 (10): 2409-17.

BackgroundWe evaluated the effectiveness of eradication of methicillin-resistant Staphylococcus aureus (MRSA) carriage in the Netherlands after the introduction of a guideline in 2006. The guideline distinguishes complicated (defined as the presence of MRSA infection, skin lesions, foreign-body material, mupirocin resistance and/or exclusive extranasal carriage) and uncomplicated carriage (not meeting criteria for complicated carriage). Mupirocin nasal ointment and chlorhexidine soap solution are recommended for uncomplicated carriers and the same treatment in combination with two oral antibiotics for complicated carriage.MethodsA prospective cohort study was performed in 18 Dutch centres from 1 October 2006 until 1 October 2008.ResultsSix hundred and thirteen MRSA carriers underwent one or more decolonization treatments during the study period, mostly after hospital discharge. Decolonization was achieved in 367 (60%) patients with one eradication attempt and ultimately 493 (80%) patients were decolonized, with a median time until decolonization of 10 days (interquartile range 7-43 days). Three hundred and twenty-seven (62%) carriers were treated according to the guideline, which was associated with an absolute increase in treatment success of 20% [from 45% (91/203) to 65% (214/327)].ConclusionsSixty percent of MRSA carriers were successfully decolonized after the first eradication attempt and 62% were treated according to the guideline, which was associated with an increased treatment success.

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