Staphylococcus aureus on computer mice and keyboards in intensive care units of the Universitas Academic Hospital, Bloemfontein, and ICU staff’s knowledge of its hazards and cleaning practices

From December 1997 to March 1998, 25 methicillin-resistantStaphylococcus aureus (MRSA) isolates exhibiting negative Staphylase (Oxoid Ltd., Basingstoke, England) reactions were identified from various clinical specimens from 13 patients in six intensive care units (ICUs) or in wards following a stay in an ICU at the National Taiwan University Hospital. The characteristics of these isolates have not been previously noted in other MRSA isolates from this hospital. Colonies of all these isolates were grown on Trypticase soy agar supplemented with 5% sheep blood and were nonhemolytic and unpigmented. Seven isolates, initially reported as Staphylococcus haemolyticus (5 isolates) and Staphylococcus epidermidis (2 isolates) by the routine identification scheme and with the Vitek GPI system (bioMerieux Vitek, Inc., Hazelwood, Mo.), were subsequently identified as S. aureus by positive tube coagulase tests, standard biochemical reactions, and characteristic cellular fatty acid chromatograms. The antibiotypes obtained by the E test, coagulase types, restriction fragment length polymorphism profiles of the staphylococcal coagulase gene, and random amplified polymorphic DNA patterns generated by arbitrarily primed PCR of the isolates disclosed that two major clones disseminated in the ICUs. Clone 1 (16 isolates) was resistant to clindamycin and was susceptible to trimethoprim-sulfamethoxazole (TMP-SMZ) and was coagulase type II. Clone 2 (eight isolates) was resistant to clindamycin and TMP-SMZ and was coagulase type IV. These two epidemic clones from ICUs are unique and underline the need for caution in identifying MRSA strains with colonial morphologies not of the typical type and with negative Staphylase reactions.

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Determining the clinical significance of co-colonization of vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus in the intestinal tracts of patients in intensive care units: a case–control study

Annals of Clinical Microbiology and Antimicrobials ◽

10.1186/s12941-019-0327-8 ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

Young Kyung Yoon ◽

Min Jung Lee ◽

Yongguk Ju ◽

Sung Eun Lee ◽

Kyung Sook Yang ◽

...

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Intensive Care ◽

Clinical Outcomes ◽

Intensive Care Units ◽

Case Control Study ◽

Case Control ◽

Methicillin Resistant ◽

Vancomycin Resistant ◽

Control Study

Abstract Background The emergence of vancomycin-resistant Staphylococcus aureus (VRSA) has become a global concern for public health. The proximity of vancomycin-resistant enterococcus (VRE) and methicillin-resistant S. aureus (MRSA) is considered to be one of the foremost risk factors for the development of VRSA. This study aimed to determine the incidence, risk factors, and clinical outcomes of intestinal co-colonization with VRE and MRSA. Methods A case–control study was conducted in 52-bed intensive care units (ICUs) of a university-affiliated hospital from September 2012 to October 2017. Active surveillance using rectal cultures for VRE were conducted at ICU admission and on a weekly basis. Weekly surveillance cultures for detection of rectal MRSA were also conducted in patients with VRE carriage. Patients with intestinal co-colonization of VRE and MRSA were compared with randomly selected control patients with VRE colonization alone (1:1). Vancomycin minimum inhibitory concentrations (MICs) for MRSA isolates were determined by the Etest. Results Of the 4679 consecutive patients, 195 cases and 924 controls were detected. The median monthly incidence and duration of intestinal co-colonization with VRE and MRSA were 2.3/1000 patient-days and 7 days, respectively. The frequency of both MRSA infections and mortality attributable to MRSA were higher in the case group than in the control group: 56.9% vs. 44.1% (P = 0.011) and 8.2% vs. 1.0% (P = 0.002), respectively. Independent risk factors for intestinal co-colonization were enteral tube feeding (odds ratio [OR], 2.09; 95% confidence interval [CI] 1.32–3.32), metabolic diseases (OR, 1.75; 95% CI 1.05–2.93), male gender (OR, 1.62; 95% CI 1.06–2.50), and Charlson comorbidity index < 3 (OR, 3.61; 95% CI 1.88–6.94). All MRSA isolates from case patients were susceptible to vancomycin (MIC ≤ 2 mg/L). Conclusions Our study indicates that intestinal co-colonization of VRE and MRSA occurs commonly among patients in the ICU with MRSA endemicity, which might be associated with poor clinical outcomes.

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Effect of Chlorhexidine Bathing and Other Infection Control Practices on the Benefits of Universal Glove and Gown (BUGG) Trial: A Subgroup Analysis

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2015.33 ◽

2015 ◽

Vol 36 (6) ◽

pp. 734-737 ◽

Cited By ~ 4

Author(s):

Daniel J. Morgan ◽

Lisa Pineles ◽

Michelle Shardell ◽

Carol Sulis ◽

Daniel H. Kett ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Intensive Care ◽

Infection Control ◽

Intensive Care Units ◽

Active Surveillance ◽

Subgroup Analysis ◽

Infect Control Hosp ◽

Methicillin Resistant ◽

Chlorhexidine Bathing

AbstractWe report the results of a subgroup analysis of the Benefits of Universal Glove and Gown trial. In 20 intensive care units, the reduction in acquisition of methicillin-resistant Staphylococcus aureus observed in this trial was observed in units also using chlorhexidine bathing and in those that previously performed active surveillance.Infect Control Hosp Epidemiol 2015;00(0): 1–4

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Methicillin-resistant Staphylococcus Aureus (MRSA) in nursing homes: a danger for intensive care units? (IL15)

British Journal of Anaesthesia ◽

10.1093/bja/89s10009a ◽

2002 ◽

Vol 89 ◽

pp. 9

Author(s):

W. Lingnau ◽

N. Treml ◽

F. Allerberger

Keyword(s):

Staphylococcus Aureus ◽

Intensive Care ◽

Nursing Homes ◽

Intensive Care Units ◽

Methicillin Resistant Staphylococcus Aureus ◽

Methicillin Resistant

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Changes in the Epidemiology of Methicillin-Resistant Staphylococcus aureus in Intensive Care Units in US Hospitals, 1992-2003

Clinical Infectious Diseases ◽

10.1086/499367 ◽

2006 ◽

Vol 42 (3) ◽

pp. 389-391 ◽

Cited By ~ 371

Author(s):

R. M. Klevens ◽

J. R. Edwards ◽

F. C. Tenover ◽

L. C. McDonald ◽

T. Horan ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Intensive Care ◽

Intensive Care Units ◽

Methicillin Resistant Staphylococcus Aureus ◽

Methicillin Resistant

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Methicillin-resistant Staphylococcus aureus in intensive care units

Journal of the Royal Society of Medicine ◽

10.1258/jrsm.98.2.86 ◽

2005 ◽

Vol 98 (2) ◽

pp. 86-86

Author(s):

S. Kochhar

Keyword(s):

Staphylococcus Aureus ◽

Intensive Care ◽

Intensive Care Units ◽

Methicillin Resistant Staphylococcus Aureus ◽

Methicillin Resistant

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Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) among Patients Admitted to Adult Intensive Care Units: The STAR*ICU Trial

Infection Control and Hospital Epidemiology ◽

10.1086/662178 ◽

2011 ◽

Vol 32 (11) ◽

pp. 1057-1063 ◽

Cited By ~ 19

Author(s):

Nisha Nair ◽

Ekaterina Kourbatova ◽

Katharine Poole ◽

Charmaine M. Huckabee ◽

Patrick Murray ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Intensive Care ◽

Molecular Epidemiology ◽

Intensive Care Units ◽

Molecular Typing ◽

Prevalence Ratio ◽

The United States ◽

Resistant Bacteria ◽

Study Objective ◽

Methicillin Resistant

Background.The multicenter, cluster-randomized Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) trial was performed in 18 U.S. adult intensive care units (ICUs). It evaluated the effectiveness of infection control strategies to reduce the transmission of methicillin-resistant Staphylococcus aureus (MRSA) colonization and/or infection. Our study objective was to examine the molecular epidemiology of MRSA and assess the prevalence and risk factors for community acquired (CA)-MRSA genotype nasal carriage at the time of ICU admission.Methods.Selected MRSA isolates were subjected to molecular typing using pulsed-field gel electrophoresis.Results.Of 5,512 ICU patient admissions in the STAR*ICU trial during the intervention period, 626 (11%) had a nares sample culture result that was positive for MRSA. A total of 210 (34%) of 626 available isolates were selected for molecular typing by weighted random sampling. Of 210 patients, 123 (59%) were male; mean age was 63 years. Molecular typing revealed that 147 isolates (70%) were the USAIOO clone, 26 (12%) were USA300, 12 (6%) were USA500, 8 (4%) were USA800, and 17 (8%) were other MRSA genotypes. In a multivariate analysis, patients who were colonized with a CA-MRSA genotype (USA300, USA400, or USA1000) were less likely to have been hospitalized during the previous 12 months (PR [prevalence ratio], 0.39 [95% confidence interval (CI), 0.21-0.73]) and were less likely to be older (PR, 0.97 [95% CI, 0.95-0.98] per year) compared with patients who were colonized with a healthcare-associated (HA)-MRSA genotype.Conclusion.CA-MRSA genotypes have emerged as a cause of MRSA nares colonization among patients admitted to adult ICUs in the United States. During the study period (2006), the predominant site of CA-MRSA genotype acquisition appeared to be in the community.

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