I Daniels-Haardt

Publications of I Daniels-Haardt

• Cross-border comparison of the admission prevalence and clonal structure of meticillin-resistant Staphylococcus aureus.

  Authors: R Köck, L Brakensiek, A Mellmann, F Kipp, M Henderikx, D Harmsen, I Daniels-Haardt, C von Eiff, K Becker, M G R Hendrix, A W Friedrich

  The Journal of hospital infection. 02/2009;

  Since patient exchange between hospitals sharing a common catchment area might favour regional spread of meticillin-resistant Staphylococcus aureus (MRSA), the reliable detection of patientsSince patient exchange between hospitals sharing a common catchment area might favour regional spread of meticillin-resistant Staphylococcus aureus (MRSA), the reliable detection of patients colonised at admission is crucial. This, hospitals in the Dutch-German border area EUREGIO MRSA-net aim at synchronising their local MRSA standards in order to prevent unidentified inter-hospital as well as cross-border spread. This assumes enhanced knowledge of MRSA prevalence and risk factors associated with MRSA carriage at admission. We conducted nasal MRSA screening of all inpatients admitted to 39 German hospitals (in the period 1 November to 30 November 2006) and to one Dutch hospital (in the period 1 July to 30 September 2007) in the EUREGIO MRSA-net. A total of 390 MRSA cases were detected among 25 540 patients screened. The admission prevalence was 1.6 MRSA/100 patients (6.5% of all S. aureus) in the German and 0.5 MRSA/100 patients (1.4% of all S. aureus) in the Dutch part of the border region. Overall, the predominating S. aureus protein A gene (spa) sequence types were t003, t032 and t011. One isolate (t044) carried Panton-Valentine leukocidin (PVL) encoding genes. Altogether, 79% and 67% of all MRSA patients in the German and Dutch regions respectively, were identifiable by the classical nosocomial risk factors assessed. In patients lacking all risk factors assessed, spa types t011 and t034 were predominant (P<0.001).

• EUREGIO MRSA-net Twente/Münsterland--a Dutch-German cross-border network for the prevention and control of infections caused by methicillin-resistant Staphylococcus aureus.

  Authors: A W Friedrich, I Daniels-Haardt, R Köck, F Verhoeven, A Mellmann, D Harmsen, J. E. van Gemert-Pijnen, K Becker, M G R Hendrix

  Euro surveillance : bulletin européen sur les maladies transmissibles = European communicable disease bulletin. 09/2008; 13(35).

  Methicillin-resistant Staphylococcus aureus (MRSA) is associated with increased mortality and morbidity and a leading cause of hospital-acquired infections. Community-acquired (CA)-MRSA are a growingMethicillin-resistant Staphylococcus aureus (MRSA) is associated with increased mortality and morbidity and a leading cause of hospital-acquired infections. Community-acquired (CA)-MRSA are a growing concern worldwide. In the last 10 years, an increase in the MRSA rate from 2% to approximately 23% has been observed in Germany, while a rate under 5% has been recorded for many years in the Netherlands and Scandinavia. In the Netherlands in particular, MRSA rates have become very low in stationary care due to a consistent 'search and destroy' policy. The main focus in Germany lies on hospital-acquired MRSA, whereas the Netherlands focus on the control of the importation of MRSA cases from abroad and on CA-MRSA. As MRSA in hospitals and in the community can be a problem in cross-border health care, the European Union-funded EUREGIO MRSA-net project was established in the bordering regions Twente/Achterhoek, the Netherlands and Münsterland, Germany. The main aim of the project is the creation of a network of the major health care providers in the EUREGIO and the surveillance and prevention of MRSA infections. A spa-typing network was established in order to understand the regional and cross-border dissemination of epidemic and potentially highly virulent MRSA genotypes. As the reduction of differences in health care quality is an important prerequisite for cross-border health care, a transborder quality group comprising hospitals, general practitioners, public health authorities, laboratories, and insurerance companies has been established since 2005 equalising the quality criteria for the control of MRSA on both sides of the border.

• [Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in patients in long-term care in hospitals, rehabilitation centers and nursing homes of a rural district in Germany]

  Authors: R Woltering, G Hoffmann, I Daniels-Haardt, P Gastmeier, I F Chaberny

  Deutsche medizinische Wochenschrift (1946). 06/2008; 133(19):999-1003.

  BACKGROUND: In recent years multi-resistant pathogens, particularly methicillin-resistant Staphylococcus aureus (MRSA) have been causing increasing problems in hospitals and nursing homes. In GermanyBACKGROUND: In recent years multi-resistant pathogens, particularly methicillin-resistant Staphylococcus aureus (MRSA) have been causing increasing problems in hospitals and nursing homes. In Germany area-wide and interdisciplinary studies of prevalence of MRSA have not previously been conducted. For this reason we investigated the its prevalence in a cross-sectional study, which included patients in hospitals, rehabilitation centers and nursing homes in a rural district in Germany. METHODS AND PATIENTS: The MRSA prevalence was determined by obtaining cultures from the nose, throat and any existing skin lesions of each patient in medical institutions and nursing homes in the the Höxter district. The presence of methicillin resistance, Panton-Valentine leukocidin (PVL) gene were determined and and staphylococcal protein A (spa) typing was done. Potential risk factors for MRSA colonization were also determined. RESULTS: S. aureus was isolated from 319 of 1 083 patients (614 females, 469 males; median age 68,2 years) from five hospitals, five nursing homes und three rehabilitation centers. The MRSA prevalence was 2,5% (95% confidence interval (CI) 1,7-3,7%). In hospitals the MRSA prevalence was 3,4%, in the nursing homes 2,3% and in rehabilitation centers 1,2%, without any significant difference between these three establishments. The proportion of MRSA in all S. aureus isolates was 8,5%. The PVL gene was not detected. It was found by multivariate analysis that variables independently associated with evidence of MRSA were haemodialysis (odds ratio (OR) 11,2; 95% CI 1,9-67,4) and an acute infection in the six months before hospital admission (OR 6,5; 95% CI 1,5-29,2). The spa typing showed different regional distribution of the MRSA subtypes. With 30% the spa type t003 (ST225 clone; in Germany called "Rhine-Hessen strain") occurred most frequently, followed by t032 with 22,2% (ST22 clone, also called "Barnimer strain"). CONCLUSIONS: This first regional cross-sectional study provides supportive data for MRSA surveillance in Germany and the data provide a basis for additional preventative measures.

• [EUREGIO-projekt MRSA-net Twente/Münsterland. Creation of a regional network to combat MRSA]

  Authors: I Daniels-Haardt, F Verhoeven, A Mellmann, M G R Hendrix, J E C Gemert-Pijnen, A W Friedrich

  Gesundheitswesen (Bundesverband der Ärzte des Öffentlichen Gesundheitsdienstes (Germany)). 12/2006; 68(11):674-8.

  Over the last years, Germany has observed an increase in the prevalence of methicillin-resistant Staphylococcus (MRSA) in all S. aureus isolates from 2 % to about 25 % whereas in The Netherlands thisOver the last years, Germany has observed an increase in the prevalence of methicillin-resistant Staphylococcus (MRSA) in all S. aureus isolates from 2 % to about 25 % whereas in The Netherlands this proportion has continuously been kept below 1 % thanks to a consistent "search & destroy" policy. Both countries increasingly register so-called community-acquired (CA) MRSA which are a threat also to the healthy population without any known risk factor for MRSA carriership. The EUREGIO project "MRSA-net Twente/Münsterland" has made it its main goal to set up a German-Dutch network serving as a basis for a quality association which includes all those who are actively involved in health care provision on both sides of the border and to implement a coordinated strategy for MRSA control and prevention. The project is being carried out with the financial support of the European Union under the INTERREG-IIIA Community initiative and of the Ministry of Economics of the State of North Rhine-Westphalia. The epidemiological backbone of the MRSA-net is a genetic-based MRSA typing strategy (spa-typing) which has been developed by the Institute for Hygiene, University Hospital, Münster and which allows regional and cross-border comparability of laboratory results. The Faculty of Behavioural Sciences of the University of Twente examines MRSA hygiene protocols with regard to their acceptability and realisability with the intention of developing user-friendly, target group-oriented MRSA protocols for the EUREGIO. The health departments involved in the project play a central role in the coordination of the network partners in the municipalities. By performing their function of surveillance in accordance with Sections 23 and 36 of the Infectious Disease Control Act they provide an important contribution to enhancing MRSA control and prevention strategies. Thanks to its cross-border cooperation and exchange of knowledge and technology the EUREGIO project "MRSA-net" contributes to controlling the proliferation of MRSA in the EUREGIO and thus to removing obstacles to the free cross-border movement of patients and personnel.