Trends in annual incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in HIV-infected and HIV-uninfected patients

2013 ◽  
Vol 141 (11) ◽  
pp. 2392-2402 ◽  
Author(s):  
G. N. DELORENZE ◽  
M. A. HORBERG ◽  
M. J. SILVERBERG ◽  
A. TSAI ◽  
C. P. QUESENBERRY ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Health Plan ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incidence Rates ◽  
Infected Group ◽  
Rapid Rise ◽  
Infection Rates ◽  
Methicillin Resistant ◽  
Mrsa Infection

SUMMARYWe describe trends in incidence rates of methicillin-resistant Staphylococcus aureus (MRSA) in HIV-infected and HIV-uninfected patients enrolled in a large northern California Health Plan, and the ratio of MRSA to methicillin-susceptible S. aureus (MSSA) case counts. Between 1995 and 2010, 1549 MRSA infections were diagnosed in 14060 HIV-infected patients (11·0%) compared to 89546 MRSA infections in 6597396 HIV-uninfected patients (1·4%) (P = 0·00). A steady rise in MRSA infection rates began in 1995 in HIV-uninfected patients, peaking at 396·5 infections/100000 person-years in 2007. A more rapid rise in MRSA infection rates occurred in the HIV-infected group after 2000, peaking at 3592·8 infections/100000 in 2005. A declining trend in MRSA rates may have begun in 2008–2009. Comparing the ratio of MRSA to MSSA case counts, we observed that HIV-infected patients shouldered a greater burden of MRSA infection during most years of study follow-up compared to HIV-uninfected patients.

Increasing rates of community-acquired methicillin-resistant Staphylococcus aureus infections among HIV-infected persons

2007 ◽  
Vol 18 (8) ◽  
pp. 521-526 ◽  
Author(s):  
Nancy F Crum-Cianflone ◽  
Alina A Burgi ◽  
Braden R Hale
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
General Population ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incidence Rates ◽  
Hiv Viral Load ◽  
Syphilis Infection ◽  
Methicillin Resistant ◽  
History Of ◽  
Mrsa Infection

Community-acquired (CA) methicillin-resistant Staphylococcus aureus (MRSA) rates have rapidly increased in the general population; however, little data on recent incidence rates and risk factors of CA-MRSA infections among HIV patients appear in the literature. A retrospective study was conducted from 1993 through 2005 among patients at a large HIV clinic. Trends in CA-MRSA infection incidence rates, clinical characteristics and risk factors for CA-MRSA were evaluated. Seven percent of our cohort developed a CA-MRSA infection during the study period. The rate of CA-MRSA infections among HIV-infected population significantly increased since 2003, with an incidence of 40.3 cases/1000 person-years in 2005, which was 18-fold higher than the general population served at our facility. In all, 90% of infections were skin/soft tissue infections with a predilection for buttock or scrotal abscess formation; 21% of patients experienced a recurrent infection. Risk factors included a low CD4 count at the time of infection (odds ratio [OR] per 100 CD4 cells 0.84, P = 0.03), high maximum log10 HIV viral load (OR 4.54, P<0.001), recent use of β-lactam antibiotics (OR 6.0 for receipt of two prescriptions, P<0.001) and a history of syphilis (OR 4.55, P = 0.01). No patient receiving trimethoprim-sulfamethoxazole prophylaxis developed a CA-MRSA infection. Over the study period, CA-MRSA accounted for an increasing percentage of positive wound cultures and Staphylococcus aureus isolates, 37% and 65%, respectively, during 2005. In conclusion, CA-MRSA infections have rapidly increased among HIV-infected patients, a group which has a higher rate of these infections than the general population. Risk factors for CA-MRSA among HIV-infected patients include low current CD4 cell count, recent β-lactam antibiotic use and potentially high-risk sexual activity as demonstrated by a history of syphilis infection.

scholarly journals Utility of Methicillin-Resistant Staphylococcus aureus Nares Screening in Hospitalized Children with Acute Infectious Disease Syndromes

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1434
Author(s):  
Ashley Sands ◽  
Nicole Mulvey ◽  
Denise Iacono ◽  
Jane Cerise ◽  
Stefan H. F. Hagmann
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Hospitalized Children ◽  
Methicillin Resistant ◽  
Osteoarticular Infections ◽  
Clinical Culture ◽  
Acute Infectious Disease ◽  
Mrsa Infection ◽  
Age Range ◽  
Mrsa Colonization

Studies in adults support the use of a negative methicillin-resistant Staphylococcus aureus (MRSA) nares screening (MNS) to help limit empiric anti-MRSA antibiotic therapy. We aimed to evaluate the use of MNS for anti-MRSA antibiotic de-escalation in hospitalized children (<18 years). Records of patients admitted between 1 January 2015 and 31 December 2020 with a presumed infectious diagnosis who were started on anti-MRSA antibiotics, had a PCR-based MNS, and a clinical culture performed were retrospectively reviewed. A total of 95 children were included with a median age (range) of 2 (0–17) years. The top three diagnosis groups were skin and soft tissue infections (n = 38, 40%), toxin-mediated syndromes (n = 17, 17.9%), and osteoarticular infections (n = 14, 14.7%). Nasal MRSA colonization and growth of MRSA in clinical cultures was found in seven patients (7.4%) each. The specificity and the negative predictive value (NPV) of the MNS to predict a clinical MRSA infection were both 95.5%. About half (n = 55, 57.9%) had anti-MRSA antibiotics discontinued in-house. A quarter (n = 14, 25.5%) were de-escalated based on the negative MNS test alone, and another third (n = 21, 38.2%) after negative MNS test and negative culture results became available. A high NPV suggests that MNS may be useful for limiting unnecessary anti-MRSA therapy and thereby a useful antimicrobial stewardship tool for hospitalized children. Prospective studies are needed to further characterize the utility of MNS for specific infectious diagnoses.

Predicting Methicillin-Resistant Staphylococcus aureus (MRSA) Bloodstream Infection Incidence Rates using Canadian Nosocomial Infection Surveillance Program (CNISP)

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Jona Gjevori ◽  
Kahina Abdesselam
Keyword(s):  
Public Health ◽  
Staphylococcus Aureus ◽  
Nosocomial Infection ◽  
Bloodstream Infection ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incidence Rates ◽  
Surveillance Program ◽  
Methicillin Resistant ◽  
Infection Surveillance ◽  
Healthcare Associated

Methicillin-Resistant Staphylococcus aureus (MRSA) is among the most prevalent nosocomial pathogens globally, causing significant morbidity, mortality, and healthcare costs. MRSA bloodstream infection (BSI) incidence rates in Canadian hospitals have significantly risen by almost 60% and have a mortality of over 20% upon Intensive Care Unit admission. MRSA is believed to be spread through healthcare workers; thus, high hand hygiene compliancy in addition to environmental cleaning are the cornerstone countermeasures to disrupting its transmission. The Public Health Agency of Canada (PHAC), in collaboration with the Canadian Nosocomial Infection Surveillance Program (CNISP), conducts national, sentinel surveillance on healthcare-associated infections like MRSA. As a Student Epidemiologist, I developed a research proposal detailing two study objectives: 1) develop a regression model to predict all incident MRSA BSI rates among acute-care hospitals in Canada using CNISP MRSA BSI incident cases from 2000 to 2019, and 2) create a compartmental (Susceptible-Infected-Recovered-Deceased) model to determine the impact of various Infection Prevention and Control (IPC) measures on the risk of healthcare-associated MRSA BSI transmission specifically. This study hopes to demonstrate that proper IPC compliance is associated with lower incident MRSA BSI rates with the goal being to produce a manuscript draft by 2021. MRSA poses a serious threat to patient safety globally and is becoming a growing national public health concern in Canada; determining which IPC strategy is most effective at disrupting MRSA transmission is essential to reducing incidence and mortality rates.

scholarly journals 1230. Epidemiology and Risk Factors for Recurrent Invasive Methicillin-Resistant Staphylococcus aureus Infection: nine US States, 2006–2013

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S373-S374
Author(s):  
Ian Kracalik ◽  
Kelly Jackson ◽  
Joelle Nadle ◽  
Wendy Bamberg ◽  
Susan Petit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Infection Type ◽  
The United States ◽  
Emerging Infections ◽  
Methicillin Resistant ◽  
Initial Infection ◽  
Joint Infections ◽  
Mrsa Infection

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) causes &gt;70,000 invasive infections annually in the United States, and recurrent infections pose a major clinical challenge. We examined risk factors for recurrent MRSA infections. Methods We identified patients with an initial invasive MRSA infection (isolation from a normally sterile body site) from 2006 to 2013, through active, population-based surveillance in selected counties in nine states through the Emerging Infections Program. Recurrence was defined as invasive MRSA isolation &gt;30 days after initial isolation. We used logistic regression with backwards selection to evaluate adjusted odds ratios (aOR) associated with recurrence within 180 days, prior healthcare exposures, and initial infection type, controlling for patient demographics and comorbidities. Results Among 24,478 patients with invasive MRSA, 3,976 (16%) experienced a recurrence, including 61% (2,438) within 180 days. Risk factors for recurrence were: injection drug use (IDU) (aOR; 1.38, 95% confidence interval [CI]: 1.15–1.65), central venous catheters (aOR; 1.35, 95% CI: 1.22–1.51), dialysis (aOR; 2.00, 95% CI: 1.74–2.31), and history of MRSA colonization (aOR; 1.35, 95% CI: 1.22–1.51) (figure). Recurrence was more likely for bloodstream infections (BSI) without another infection (aOR; 2.08, 95% CI: 1.74–2.48), endocarditis (aOR; 1.46, 95% CI: 1.16–1.55), and bone/joint infections (aOR; 1.38, 95% CI: 1.20–1.59), and less likely for pneumonia (aOR: 0.75, 95% CI: 0.64–0.89), compared with other initial infection types. When assessed separately, the presence of a secondary BSI with another infection increased the odds of recurrence over that infection without a BSI (aOR: 1.96, 95% CI: 1.68–2.30). Conclusion Approximately one in six persons with invasive MRSA infection had recurrence. We identified potential opportunities to prevent recurrence through infection control (e.g., management and early removal of central catheters). Other possible areas for preventing recurrence include improving the management of patients with BSI and bone/joint infections (including both during and after antibiotic treatment) and mitigating risk of infection from IDU. Disclosures All authors: No reported disclosures.

scholarly journals MRSA – ‘Bug-Bear’ of a Surgical Practice: Reducing the Incidence of MRSA Surgical Site Infections

2006 ◽  
Vol 88 (2) ◽  
pp. 222-223 ◽  
Author(s):  
Andrea Guyot ◽  
Graham Layer
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Orthopaedic Surgery ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Infection Rates ◽  
Methicillin Resistant ◽  
Surgical Practice ◽  
Department Of Health

Adverse publicity (the ‘superbug') has demonstrated that the problem of MRSA (methicillin-resistant Staphylococcus aureus) is prevalent in many of the country's most prestigious hospitals. The results of the mandatory UK Department of Health (DH) surveillance for early surgical site infections in orthopaedic surgery (SSIS) have been published recently for the period April 2004 to March 2005 when 41,242 operations were studied (< http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsStatistic > 28 October 2005). Infection rates were generally and gratifyingly low but 48% of surgical site infections were caused by Staph. aureus and of those 68% were MRSA. The following article will discuss the aetiology and prevention of MRSA surgical site infection.

scholarly journals Marked increase in community-associated methicillin-resistant Staphylococcus aureus infections, Western Australia, 2004–2018

2020 ◽  
Vol 148 ◽  
Author(s):  
L. E. Bloomfield ◽  
G. W. Coombs ◽  
S. Tempone ◽  
P. K. Armstrong
Keyword(s):  
Staphylococcus Aureus ◽  
Western Australia ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incidence Rates ◽  
Climatic Conditions ◽  
Socioeconomic Disadvantage ◽  
Surveillance Data ◽  
Ecological Niches ◽  
Methicillin Resistant ◽  
Behavioural Factors

Abstract This study presents enhanced surveillance data from 2004 to 2018 for all community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) specimens collected in Western Australia (WA), and describes the changing epidemiology over this period. A total of 57 557 cases were reviewed. Annual incidence rates increased from 86.2 cases per 100 000 population to 245.6 per 100 000 population (IRR = 2.9, CI95 2.7–3.0). The proportion of isolates carrying Panton–Valentine leucocidin (PVL)-associated genes increased from 3.4% to 59.8% (χ2 test for trend 7021.9, P < 0.001). The emergence of PVL-positive, ‘Queensland CA-MRSA’ (ST93-IV) and ‘WA 121’ (ST5-IV) accounted for the majority of increases in CA-MRSA across the study period. It is unclear why some clones are more prolific in certain regions. In WA, CA-MRSA rates increase as indices of temperature and humidity increase after controlling for socioeconomic disadvantage. We suggest climatic conditions may contribute to transmission, along with other socio-behavioural factors. A better understanding of the ability for certain clones to form ecological niches and cause outbreaks is required.

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