A Prolonged Outbreak of Methicillin-Resistant Staphylococcus aureus in the Burn Unit of a Tertiary Medical Center

1996 ◽  
Vol 17 (12) ◽  
pp. 798-802 ◽  
Author(s):  
Patricia A. Meier ◽  
Cheryl D. Carter ◽  
Sarah E. Wallace ◽  
Richard J. Hollis ◽  
Michael A. Pfaller ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Healthcare Workers ◽  
Medical Center ◽  
Tertiary Care ◽  
Chromosomal Dna ◽  
Methicillin Resistant ◽  
Persistent Problem ◽  
Tertiary Care Medical Center ◽  
Burn Unit

AbstractObjective:To report an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in our burn unit and the steps we used to eradicate the organism.Design And Setting:Outbreak investigation in the burn unit of a 900-bed tertiary-care medical center.Outbreak:Between March and June 1993, MRSA was isolated from 10 patients in our burn unit. All isolates had identical antibiograms and chromosomal DNA patterns.Control Measures:Infection control personnel encouraged healthcare workers to wash their hands after each patient contact. The unit cohorted all infected or colonized patients, placed each affected patient in isolation, and, if possible, transferred the patient to another unit. Despite these measures, new cases occurred. Infection control personnel obtained nares cultures from 56 healthcare workers, 3 of whom carried the epidemic MRSA strain. One healthcare worker cared for six affected patients, and one cared for five patients. We treated the three healthcare workers with mupirocin. Subsequently, no additional patients became colonized or infected with the epidemic MRSA strain.Conclusions:The outbreak ended after we treated healthcare workers who carried the epidemic strain with mupirocin. This approach is not appropriate in all settings. However, we felt it was justified in this case because of a persistent problem after less intrusive measures.

scholarly journals Prior Vancomycin Use Is a Risk Factor for Reduced Vancomycin Susceptibility in Methicillin-Susceptible but Not Methicillin-Resistant Staphylococcus aureus Bacteremia

2012 ◽  
Vol 33 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Kara B. Mascitti ◽  
Paul H. Edelstein ◽  
Neil O. Fishman ◽  
Knashawn H. Morales ◽  
Andrew J. Baltus ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Center ◽  
Tertiary Care ◽  
Methicillin Resistant ◽  
Staphylococcus Aureus Bacteremia ◽  
Tertiary Care Medical Center ◽  
Healthcare Acquired Infections ◽  
Mrsa Infection ◽  
Substantial Morbidity ◽  
Mssa Infection

Objective.Staphylococcus aureus is a cause of community- and healthcare-acquired infections and is associated with substantial morbidity, mortality, and costs. Vancomycin minimum inhibitory concentrations (MICs) among S. aureus have increased, and reduced vancomycin susceptibility (RVS) may be associated with treatment failure. We aimed to identify clinical risk factors for RVS in S. aureus bacteremia.Design.Case-control.Setting.Academic tertiary care medical center and affiliated urban community hospital.Patients.Cases were patients with RVS S. aureus isolates (defined as vancomycin E-test MIC >1.0 μg/mL). Controls were patients with non-RVS S. aureus isolates.Results.Of 392 subjects, 134 (34.2%) had RVS. Fifty-eight of 202 patients (28.7%) with methicillin-susceptible S. aureus (MSSA) isolates had RVS, and 76 of 190 patients (40.0%) with methicillin-resistant S. aureus (MRSA) isolates had RVS (P = .02). In unadjusted analyses, prior vancomycin use was associated with RVS (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.00–4.32; P = .046). In stratified analyses, there was significant effect modification by methicillin susceptibility on the association between vancomycin use and RVS (P = .04). In multivariate analyses, after hospital of admission and prior levofloxacin use were controlled for, the association between vancomycin use and RVS was significant for patients with MSSA infection (adjusted OR, 4.02; 95% CI, 1.11–14.50) but not MRSA infection (adjusted OR, 0.87; 95% CI, 0.36–2.13).Conclusions.A substantial proportion of patients with S. aureus bacteremia had RVS. The association between prior vancomycin use and RVS was significant for patients with MSSA infection but not MRSA infection, suggesting a complex relationship between the clinical and molecular epidemiology of RVS in S. aureus.Infect Control Hosp Epidemiol 2012;33(2):160-166

scholarly journals Understanding the Local Epidemiology of Methicillin-Resistant Staphylococcus aureus by Pulsed-Field Gel Electrophoresis in an Indian Tertiary Care Centre

2021 ◽  
Author(s):  
Avinandan Saha ◽  
Priyanka Prasad ◽  
Gita Nataraj
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Gel Electrophoresis ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Methicillin Resistant ◽  
Pulsed Field ◽  
Hospital Infection Control ◽  
Prospective Longitudinal

Abstract Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of community and hospital-acquired infections (HAIs). In the year preceding this study, our laboratory reported an MRSA isolation rate of 2% from 50,549 specimens. Molecular typing of MRSA identifies sources of infection, transmission chains and informs infection control practices, and pulsed-field gel electrophoresis (PFGE) is the gold standard. This study was conducted to gain an understanding of the local molecular epidemiology of MRSA in our hospital using PFGE, to inform hospital infection control practices.Methods: This prospective longitudinal study was conducted in the microbiology laboratory of our 2,200-bed tertiary care teaching hospital in Mumbai, India.The antibiotic susceptibility profiles and pulsed-field profiles (PFPs) of 100 consecutive non-duplicate clinical isolates of MRSA were obtained. The PFPs were compared to check for relatedness of isolates. The distribution of various pulsotypes across disciplines and hospital locations was examined.Results: Clinical specimens accounted for 86 (86%) of the MRSA isolates, whilst 14 (14%) were from screening of healthcare workers. Maximum isolates, 68 (68%), were from surgical disciplines. Confirmed HAIs accounted for 25 (25%) MRSA isolates. Seventeen antibiotypes were obtained and there was no correlation between antibiotype and pulsotype. Totally 43 pulsotypes were identified, with most isolates, 40 (40%), belonging to pulsotype 1. Seven clusters were identified. Cluster I had maximum pulsotypes, 14, and 58 (58%) isolates. Isolates belonging to clusters I and II were found in all hospital locations. Relatedness was observed between isolates from HAIs and screening specimens, and between community and HAI isolates.Conclusions: PFGE typing revealed the disciplines at greatest risk from MRSA in our hospital. The commonality between MRSA isolated from HAIs and screening of healthcare workers, and between MRSA isolated from HAIs and from community-acquired infections highlighted the horizontal transmission of MRSA and the need to reinforce infection control measures to limit this.

Nosocomial Methicillin-Resistant and Methicillin-SusceptibleStaphylococcus AureusPrimary Bacteremia: At What Costs?

1999 ◽  
Vol 20 (6) ◽  
pp. 408-411 ◽  
Author(s):  
Murray A. Abramson ◽  
Daniel J. Sexton
Keyword(s):  
Hospital Stay ◽  
Medical Center ◽  
A Priori ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Bloodstream Infections ◽  
Methicillin Resistant ◽  
Tertiary Care Medical Center ◽  
Matching Criteria ◽  
Nested Case Control

Objective:To determine the attributable hospital stay and costs for nosocomial methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistantS aureus(MRSA) primary bloodstream infections (BSIs).Design:Pairwise-matched (1:1) nested case-control study.Setting:University-based tertiary-care medical center.Patients:Patients admitted between December 1993 and March 1995 were eligible. Cases were defined as patients with a primary nosocomialS aureusBSI; controls were selected according to a priori matching criteria.Measurements:Length of hospital stay and total and variable direct costs of hospitalization.Results:The median hospital stay attributable to primary nosocomial MSSA BSI was 4 days, compared with 12 days for MRSA (P=.023). Attributable median total cost for MSSA primary nosocomial BSIs was $9,661 versus $27,083 for MRSA nosocomial infections (P=.043).Conclusion:Nosocomial primary BSI due toS aureussignificantly prolongs the hospital stay. Primary nosocomial BSIs due to MRSA result in an approximate threefold increase in direct cost, compared with those due to MSSA.

The Decrease in Healthcare-Associated Methicillin-Resistant Staphylococcus aureus Infections and Savings From Glycopeptide Use

2006 ◽  
Vol 27 (10) ◽  
pp. 1131-1132 ◽  
Author(s):  
Diler Coşkun ◽  
Jale Aytaç
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Medical Center ◽  
Methicillin Resistant ◽  
Healthcare Associated

We evaluated changes in the rate of healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) infections and healthcare-associated S. aureus infections after implementation of infection control precautions and the effect of this on glycopeptide use and expenditures for glycopeptides in a private medical center in Turkey in the years 2000-2005. A striking decrease was obtained in the number of MRSA infections, and the expenditure for glycopeptide use also decreased

Perception vs Reality: Methicillin-Resistant Staphylococcus aureus Carriage Among Healthcare Workers at a Veterans Affairs Medical Center

2015 ◽  
Vol 37 (1) ◽  
pp. 110-112 ◽  
Author(s):  
Nora E. Colburn ◽  
Jennifer Cadnum ◽  
Elizabeth Flannery ◽  
Shelley Chang ◽  
Curtis J. Donskey ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Healthcare Workers ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Medical Center ◽  
Veterans Affairs ◽  
Infect Control Hosp ◽  
Prevalence Study ◽  
Methicillin Resistant ◽  
Knowledge Deficit

In a prevalence study of 209 healthcare workers, 18 (8.6%) and 13 (6.2%) carried methicillin-resistant Staphylococcus aureus in their nares or on their hands, respectively. However, 100 (62%) of 162 workers completing an associated survey believed themselves to be colonized, revealing a knowledge deficit about methicillin-resistant Staphylococcus aureus epidemiology.Infect. Control Hosp. Epidemiol. 2015;37(1):110–112

A cross sectional study to assess nasal carriage of methicillin resistant Staphylococcus aureus in healthcare professionals in a tertiary care hospital

2020 ◽  
pp. 1-12
Author(s):  
Fibhaa Syed ◽  
Nasim Akhtar ◽  
Mohammad Ali Arif ◽  
Adil Ramzan ◽  
Rauf Niazi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Healthcare Workers ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Nasal Carriage ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Cross Sectional ◽  
Methicillin Resistant ◽  
Nasal Swabs

Abstract Objective: To determine the nasal carriage of staphylococcus aureus and methicillin-resistant staphylococcus aureus among healthcare workers in a tertiary care setting. Methods: The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from April to July 2018, and comprised healthcare workers at the institution. Nasal swabs were collected and cultured on Mannitol salt agar. Mannitol fermenting colonies which were gram-positive cocci, catalase-positive and coagulase-positive were identified as staphylococcus aureus. Antibiotic susceptibility test was performed by modified Kirby-Bauer disc diffusion method. Methicillin resistance was detected using cefoxitin disc diffusion method. Data was analysed using SPSS 23. Results: Of the 210 nasal swabs, 52(24.76%) had a staphylococcus aureus growth, and, of them, 15(7.1%) were methicillin-resistant. No association could be established with either any single category of healthcare worker or an inter-department variation (p>0.05). Likewise, there was no association with age, gender, duration of service, smoking, co-morbidities, use of antibiotics in the preceding six months, treating a patient with methicillin-resistant staphylococcus aureus in the preceding six months and hospitalisation in the preceding year (p>0.05). Conclusion: The frequency of nasal carriage of methicillin resistant staphylococcus aureus amongst healthcare workers was regardless of the nature of their professional engagement. Key Words: Methicillin resistant staphylococcus aureus, Nasal carriage, Continuous...

“The Coccus-Conscious” or “The Conscious Careful”

1987 ◽  
Vol 8 (1) ◽  
pp. 34-35 ◽  
Author(s):  
Albert F. Brown ◽  
Joan L. Otterman
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Hospital Infection ◽  
Methicillin Resistant ◽  
Persistent Problem ◽  
Control Programs ◽  
Hospital Infection Control ◽  
To Come

Staphylococcus aureus continues to be a resilient and persistent problem for hospital infection control programs. Now methicillin-resistant S. aureus (MRSA) is emerging as an even more formidable foe, bringing with it controversies in laboratory reporting, treatment, and isolation strategies.History suggests that the best solution to the hospital bacteria problem may well lie in the realm of spirit more than material methods. So, in the manner of Dickens' Christmas Carol fantasy, let us travel with three spirits— the Spirit of Conscience Past, the Spirit of Conscience Present, and the Spirit of Conscience to Come.

scholarly journals Impact of Bordetella pertussis Exposures on a Massachusetts Tertiary Care Medical System

2007 ◽  
Vol 28 (6) ◽  
pp. 708-712 ◽  
Author(s):  
Iva Zivna ◽  
Diana Bergin ◽  
Joanne Casavant ◽  
Sally Fontecchio ◽  
Susan Nelson ◽  
...  
Keyword(s):  
Bordetella Pertussis ◽  
Healthcare Workers ◽  
Close Contact ◽  
Medical Center ◽  
Tertiary Care ◽  
Medical System ◽  
Secondary Case ◽  
Tertiary Care Medical Center ◽  
Outbreak Investigations ◽  
The Impact

Objective.To assess the impact of outbreaks of Bordetella pertussis infection on a tertiary care medical system.Design.Retrospective study.Setting.Academic tertiary care medical center and affiliated ambulatory care settings.Subjects.All patients and healthcare workers (HCWs) who were in close contact with patients with laboratory-confirmed cases of B. pertussis infection from October 1, 2003, through September 30, 2004.Intervention.Direct and indirect medical center costs were determined, including low and high estimates of time expended in the evaluation and management of exposed patients and HCWs during outbreak investigations of laboratory-confirmed cases of B. pertussis infection.Results.During this period, 20 primary and 3 secondary laboratory-confirmed cases of B. pertussis infection occurred, with 2 primary pertussis cases and 1 secondary case occurring in HCWs. Outbreak investigations prompted screening of 353 medical center employees. Probable or definitive exposure was identified for 296 HCWs, and 287 subsequently received treatment or prophylaxis for B. pertussis infection. Direct medical center costs for treatment and prophylaxis were $13,416 and costs for personnel time were $19,500-$31,190. Indirect medical center costs for time lost from work were $51,300-$52,300. The total cost of these investigations was estimated to be $85,066-$98,456.Conclusions.Frequent B. pertussis exposures had a major impact on our facility. Given the impact of exposures on healthcare institutions, routine vaccination for HCWs may be beneficial.

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