Post-discharge decolonization of patients harboring methicillin-resistant Staphylococcus aureus (MRSA) USA300 strains: secondary analysis of the CLEAR Trial

Author(s):  
Gabrielle M. Gussin ◽  
Lauren Heim ◽  
Thomas Tjoa ◽  
James A. McKinnell ◽  
Loren G. Miller ◽  
...  

Abstract The CLEAR Trial recently found that decolonization reduced infections and hospitalizations in MRSA carriers in the year following hospital discharge. In this secondary analysis, we explored whether decolonization had a similar benefit in the subgroup of trial participants who harbored USA300, using two different definitions for the USA300 strain-type.

2019 ◽  
Vol 8 (18) ◽  
Author(s):  
Jo-Ann McClure ◽  
Kunyan Zhang

USA300 is a predominant community-associated methicillin-resistant Staphylococcus aureus strain causing significant morbidity and mortality in North America. We present the full annotated genome sequences of two methicillin-resistant Staphylococcus aureus isolates related to the USA300 pulsotype with the goal of studying the evolutionary relationships of this highly successful strain type.


2011 ◽  
Vol 6 (03) ◽  
pp. 223-233 ◽  
Author(s):  
Asghar Nazeer ◽  
Jaffar A. Al-Tawfiq

Introduction: The World Health Organization recommends essential measures to "combat drug resistance", including instituting surveillance "everywhere". Standardized metrics are crucial for reliable surveillance. Studies publish metrics with varying definitions for multi-drug resistant organisms (MDRO). The Society for Healthcare Epidemiology of America (SHEA) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) proposed standardized metrics for MDRO for consistent reporting, identifying high-risk groups, and evaluating interventions. Methodology: We retrieved 73 studies through PubMed using the search terms "methicillin-resistant Staphylococcus aureus", "MRSA", and "Saudi Arabia". We selected 20 studies that reported MRSA incidence or prevalence in patients and/or percentage among Staphylococcus aureus isolates and evaluated these metrics against the closest matching SHEA/HICPAC metrics. Results: We outlined issues applicable to MRSA metrics such as comparison of risk-unadjusted metrics; their pooling for different hospitals; not accounting for post-discharge infections; non-specification of AST-based, and healthcare and community associated infections' related, standardized metrics by SHEA/HICPAC; and appropriate temporal criteria for nosocomial infections. We elaborated salient features of reviewed metrics versus their SHEA/HICPAC complements. Terminology and definitions of reviewed metrics differed from SHEA/HICPAC counterparts. Some did not satisfy the epidemiological or statistical criteria for their reported category; e.g. prevalence indicators were classified as incidence and vice versa. Conclusions: SHEA/HICPAC metrics would be useful for future studies. Our results show an imminent need for an international consensus on fundamental MDRO surveillance metrics; illustrate surveillance scenarios requiring standardized metrics; identify some indicators from Saudi studies supplementing SHEA/HICPAC metrics; and underscore SHEA/HICPAC's advice for avoiding comparison of risk-unadjusted metrics between hospitals.


Author(s):  
Anastasiia S. Weiland ◽  
Julia Y. Lu ◽  
Caleb S. Chen ◽  
Thomas Tjoa ◽  
Raveena Singh ◽  
...  

ABSTRACT We performed secondary analyses of a postdischarge decolonization trial of MRSA carriers that reduced MRSA infection and hospitalization by 30%. Hospitalized MRSA infection was associated with 7.9 days of non-MRSA antibiotics and CDI in 3.9%. Preventing MRSA infection and associated hospitalization may reduce antibiotic use and CDI incidence.


2012 ◽  
pp. 19-27 ◽  
Author(s):  
Oscar Correa ◽  
Kelly Delgado ◽  
Carla Rangel ◽  
Ana Bello ◽  
Niradiz Reyes

Introduction: The host niche for Staphylococcus aureus (SA) are the anterior nares; however, vaginal colonization rates between 14% and 17.1% in pregnant women have been recently reported, raising interest about the potential risk in postpartum women and in neonates from colonized mothers. Objectives: To determine the prevalence of nasal and vaginal colonization of SA and the antibiotic susceptibility of the isolates in pregnant women attending a maternity hospital in Cartagena, Colombia. Methods: Nasal and vaginal swabs were obtained from participants and subjected to microbiological and molecular assays. A post discharge follow-up was performed for up to four weeks. Results: From 100 pregnant women enrolled in the study, 34 were colonized with SA; 29 only in the nares, three only in the vagina, and two at both sites. Colonization of pregnant women with SA was more common in the nares than in the vagina or at both sites [29/34 (85.3%) vs 3/34 (8.8%) and 2/34 (5.9%); p<0.05]. We obtained 36 SA isolates, nine (25%) of which were methicillin-resistant Staphylococcus aureus (MRSA), one was from the vagina; thus, the overall MRSA colonization rate among pregnant women was 9%. Molecular analysis showed that Panton-Valentine leukocidin (PVL) genes were carried by the vaginal MRSA, seven of the nasal MRSA, and two of the Methicillinsensitive Staphylococcus aureus (MSSA) isolates. Two MRSA isolates carried SCCmec type I and seven carried SCCmec type IV. Conclusions: Nasal colonization rate for SA in the study population was similar to previous reports. However, the frequency of nasal colonization of MRSA was higher while vaginal colonization of SA was lower than previously reported in other studies for similar populations. The MRSA isolates obtained showed a community profile.


Chemotherapy ◽  
2019 ◽  
Vol 64 (5-6) ◽  
pp. 233-237
Author(s):  
Thomas J. Dilworth ◽  
Daniel Sanchez ◽  
Beverly Anderson ◽  
Haedi DeAngelis ◽  
Renée-Claude Mercier

Previous studies have demonstrated synergy between piperacillin (PIP)-tazobactam (TAZ) (TZP) and vancomycin (VAN) against methicillin-resistant Staphylococcus aureus (MRSA). However, it is unknown whether PIP and/or TAZ synergizes with VAN against MRSA. We sought to determine whether PIP and/or TAZ synergizes with VAN against MRSA in vitro. The activity of PIP and/or TAZ with and without VAN (1/2 the minimum inhibitory concentration) was tested against 5 clinical MRSA isolates using a 24-h time-kill methodology. Antibiotic susceptibilities, accessory gene regulator (agr) operon functionality, and US strain type were also determined for the isolates. The combination of VAN and TZP was bactericidal against 3/5 isolates and synergistic against 4/5 isolates tested. Neither PIP nor TAZ alone combined with VAN demonstrated a significant reduction in bacterial growth. The combination of TZP and VAN was less active against the lone isolate with agr dysfunction. In summation, the combination of VAN with both PIP and TAZ was required for synergy against MRSA. This antibiotic combination may not be effective against unique MRSA strain types.


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