MRSA: The Dutch Approach

ISSUE: The Dutch Workingparty on Infection Prevention (WIP) is a foundation established by three societies engaged in infection prevention: the Dutch ICP Society, the Society of Infectious Diseases, and the Society for Medical Microbiology. The WIP establishes guidelines for the prevention of infections in intramural and extramural healthcare. The WIP guidelines should be considered a description of the optimum measures drawn up by a group of experts with advice from individuals actively involved in the relevant field. The guidelines of the WIP are considered professional standards on the basis of the Quality Law for Healthcare of the Dutch government, through the Inspectorate of Health Care. PROJECT: The WIP produced a guideline to prevent MRSA which is based on the so-called Search and Destroy policy. This means keeping patients suspected of being colonized or infected with MRSA in strict isolation. The rapid recognition of patients with MRSA is essential in order to take steps early whenever MRSA is suspected. Because it has been found that patients who have been hospitalized in foreign countries can be colonized with MRSA, it is important that preventive measures be taken as soon as such individuals are admitted. RESULTS: Together with the prudent use of antibiotics, the Dutch approach has been successful in keeping the incidence of MRSA below 1%. CONCLUSIONS: The government, through the Inspectorate of Health Care, plays an active role in this approach by stimulating the work of the WIP and by inspecting hospitals. To control and support the MRSA approach, there is also a national surveillance system for MRSA.