2026/06/29 by A. Bauer, P. Martus, P Martus +20
Medicine · #Antimicrobial Resistance in Staphylococcus #Infection Control in Healthcare #Surgical site infection prevention
paper · pdf · doi:10.1016/j.jhin.2026.02.014
BACKGROUND: Although 90% of Staphylococcus aureus (SA) cases in hospitals are community-acquired, decolonisation strategies primarily target inpatients. The STAUfrei Project explored an intersectoral approach with outpatient screening and decolonisation prior to hospitalization. This study examined feasibility, patient adherence, and its link to decolonisation success. METHODS: Of N=8054 patients (>18 years) with planned surgery at a hospital in southwest Germany, all intervention patients (n=3390) with a positive S. aureus result at enrolment between 2019-2022 were invited to participate in a sub-study. Data was collected via a questionnaire and decolonisation diary. Colonized patients completed a five-day regimen with measures administered three times daily. Questionnaire data was analysed descriptively; the association between adherence and colonization at admission was assessed via logistic regression. RESULTS: A total of N=2147 patients participated in the survey. For analysis, only those with at least one decolonisation diary entry and a positive SA result at baseline were included (N=588). Patient acceptance of decolonisation measures was high: 86.9% reported good to very good implementability, and most considered both the duration (87.4%) and daily effort (78.7%) acceptable. A quarter adhered to over 80% of the measures, while only 6.6% achieved full adherence. Adherence was lowest at midday. Higher adherence was linked to lower colonization rates, though not statistically significant. CONCLUSION: Questionnaire data showed high feasibility and adherence to home-based decolonisation. Higher adherence was linked to lower colonization rates at admission. Further research is needed to define the optimal composition of effective outpatient measures.