Surveillance and Control of Methicillin-Resistant Staphylococcus aureus Infections in French Hospitals

2001 ◽  
Vol 22 (11) ◽  
pp. 677-682 ◽  
Author(s):  
Didier Lepelletier ◽  
Hervé Richet
Keyword(s):  
Staphylococcus Aureus ◽  
Representative Sample ◽  
Public Hospitals ◽  
Infection Rates ◽  
Surveillance Programs ◽  
Mrsa Infection ◽  
Data Surveillance ◽  
Resistance Rates ◽  
And Control ◽  
Mrsa Colonization

AbstractObjective:To assess the way French hospitals conduct surveillance for, and control infections caused by, methicillin-resis-tant Staphylococcus aureus (MRSA), and to evaluate the incidence of these infections.Design:Retrospective analysis of sample surveillance data.Setting:Representative sample of French hospitals.Participants:Representative sample of 38 French public hospitals.Methods:Hospitals were selected randomly in 1996, taking into account their location and number of beds. Administrative data, surveillance denominators used, antimicrobial resistance rates, and infection control practices were analyzed for the period 1990 to 1995. The same 38 centers were contacted 3 years later, in 1998, to reassess their surveillance and control activities.Results:French hospitals were slow to implement MRSA surveillance programs; only 5% had such programs in 1990, when the median incidence per admission (0.37%) and per patient-days (0.04%) of MRSA infections was already high. Despite the implementation of surveillance programs in 66% of French hospitals in 1995 and 87% in 1998, the MRSA infection rates remained stable from 1990 to 1995 and increased from 1995 to 1998. The proportion of French hospitals having a policy for the transfer of MRSA-infected patients to other hospitals increased from 47% in 1995 to 61% in 1998, whereas screening for MRSA colonization (42%-53%) and isolation for colonized or infected patients (87%-89%) remained stable.Conclusions:This first national survey showed that French hospitals probably were not optimally prepared to control and prevent MRSA infections, since they were slow to respond to the growing problem.

Efficacy of Pre-Operative MRSA Screening in Otolaryngology

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P71-P71 ◽  
Author(s):  
Sara L Richer ◽  
Barry L Wenig
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infections ◽  
Time Frame ◽  
Infectious Complications ◽  
Preoperative Treatment ◽  
Infection Rates ◽  
Early Results ◽  
Mrsa Infection ◽  
One Year ◽  
Mrsa Colonization

Objective To examine the efficacy of pre-operative Staphylococcus aureus screening by nasal swab on post-operative Methicillin-resistant Staphylococcus aureus (MRSA) infection rates in surgical patients undergoing varied otolaryngological procedures. Methods Retrospective review of MRSA colonization and infection rates in surgical otolaryngology patients at a single institution. MRSA infection rates in unscreened patients undergoing procedures during a one-year period were compared to infection rates in patients undergoing pre-operative Staphylococcus aureus screening in an 11-month time frame. Patients colonized with Staphylococcus aureus were treated with Mupirocin and Chlorhexidine prior to the procedure. Results Records of 420 patients undergoing varied otolaryngological procedures were evaluated. In the 241 patients without pre-operative screening, 9 patients had Staphylococcus aureus-infected wounds. There were two (0.83%) post-operative MRSA surgical site infections. Out of 179 patients followed after screening was initiated, 24 patients (13.4%) were colonized with Staphylococcus aureus and underwent preoperative treatment. There were no MRSA infections in the post-operative period. Conclusions Early results demonstrate the potential benefit of pre-operative Staphylococcus aureus screening in reducing the MRSA infection rate. Screening and treatment of MRSA colonized patients pre-operatively reduces infectious complications and should be considered in otolaryngology surgical practice.

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.

Colonization With Methicillin-Resistant Staphylococcus aureus in ICU Patients Morbidity, Mortality, and Glycopeptide Use

2001 ◽  
Vol 22 (11) ◽  
pp. 687-692 ◽  
Author(s):  
Maité Garrouste-Orgeas ◽  
Jean-Francois Timsit ◽  
Hatem Kallel ◽  
Adel Ben Ali ◽  
Marie Francoise Dumay ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Icu Mortality ◽  
Icu Patients ◽  
Methicillin Resistant ◽  
Saps Ii ◽  
Icu Stay ◽  
Mrsa Infection ◽  
The Impact ◽  
Mrsa Colonization

Abstract Objective: To determine the impact of methicillin-resis-tant Staphylococcus aureus (MRSA) colonization on the occurrence of S aureus infections (methicillin-resistant and methicillin-suscep-tible), the use of glycopeptides, and outcome among intensive care unit (ICU) patients. Design: Prospective observational cohort survey. Setting: A medical-surgical ICU with 10 single-bed rooms in a 460-bed, tertiary-care, university-affiliated hospital. Patients: A total of 1,044 ICU patients were followed for the detection of MRSA colonization from July 1, 1995, to July, 1 1998. Methods: MRSA colonization was detected using nasal samples in all patients plus wound samples in surgical patients within 48 hours of admission or within the first 48 hours of ICU stay and weekly thereafter. MRSA infections were defined using Centers for Disease Control and Prevention standard definitions, except for ventilator-associated pneumonia and catheter-related infections, which were defined by quantitative distal culture samples. Results: One thousand forty-four patients (70% medical patients) were included in the analysis. Mean age was 61±18 years; mean Simplified Acute Physiologic Score (SAPS) II was 36.4±20; and median ICU stay was 4 (range, 1-193) days. Two hundred thirty-one patients (22%) died in the ICU. Fifty-four patients (5.1%) were colonized with MRSA on admission, and 52 (4.9%) of 1,044 acquired MRSA colonization in the ICU. Thirty-five patients developed a total of 42 S aureus infections (32 MRSA, 10 methi-cillin-susceptible). After factors associated with the development of an S aureus infection were adjusted for in a multivariate Cox model (SAPS II &gt;36: hazard ratio [HR], 1.64; P=.09; male gender: HR, 2.2; P=.05), MRSA colonization increased the risk of S aureus infection (HR, 3.84; P=.0003). MRSA colonization did not influence ICU mortality (HR, 1.01; P=.94). Glycopeptides were used in 11.4% of the patients (119/1,044) for a median duration of 5 days. For patients with no colonization, MRSA colonization on admission, and ICU-acquired MRSA colonization, respectively, glycopeptide use per 1,000 hospital days was 37.7, 235.2, and 118.3 days. MRSA colonization per se increased by 3.3-fold the use of glycopeptides in MRSA-colonized patients, even when an MRSA infection was not demonstrated, compared to non-colonized patients. Conclusions: In our unit, MRSA colonization greatly increased the risk of S aureus infection and of glycopeptide use in colonized and non-colonized patients, without influencing ICU mortality. MRSA colonization influenced glycopeptide use even if an MRSA infection was not demonstrated; thus, an MRSA control program is warranted to decrease vancomycin use and to limit glycopeptide resistance in gram-positive cocci.

scholarly journals Effects of DQ-113, a New Quinolone, against Methicillin- and Vancomycin-Resistant Staphylococcus aureus-Caused Hematogenous Pulmonary Infections in Mice

2003 ◽  
Vol 47 (12) ◽  
pp. 3694-3698 ◽  
Author(s):  
Yukihiro Kaneko ◽  
Katsunori Yanagihara ◽  
Yoshitsugu Miyazaki ◽  
Kazuhiro Tsukamoto ◽  
Yoichi Hirakata ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Histopathological Examination ◽  
Untreated Group ◽  
The Other ◽  
Infection Model ◽  
Pulmonary Infections ◽  
Viable Bacteria ◽  
Mrsa Infection ◽  
And Control ◽  
Inflammatory Changes

ABSTRACT We compared the effects of DQ-113, a new quinolone, to those of vancomycin (VCM) and teicoplanin (TEIC) in murine models of hematogenous pulmonary infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and VCM-insensitive S. aureus (VISA). The MICs of DQ-113, VCM, and TEIC for MRSA were 0.125, 1.0, and 0.5μ g/ml, respectively; and those for VISA were 0.25, 8.0, and 8.0μ g/ml, respectively. Treatment with DQ-113 resulted in a significant decrease in the number of viable bacteria in the lungs of the mice used in the MRSA infection model (counts in mice treated with DQ-113, VCM, and TEIC and control mice, 6.33 ± 0.22, 7.99± 0.14, 7.36 ± 0.20, and 8.47 ± 0.22 log10 CFU/lung [mean ± standard error of the mean], respectively [P < 0.01 for the group treated with DQ-113 compared with the group treated with VCM or TEIC or the untreated group]). Mice infected with VISA were pretreated with cyclophosphamide, and the survival rate was recorded daily for 10 days. At the end of this period, 90% of the DQ-113-treated mice were still alive, whereas only 45 to 55% of the mice in the other three groups were still alive (P < 0.05 for the group treated with DQ-113 compared with the group treated with VCM or TEIC or the untreated group]). DQ-113 also significantly (P < 0.05) reduced the number of viable bacteria in the lungs compared with those in the lungs of the other three groups (counts in mice treated with DQ-113, VCM, and TEIC and control mice, 5.76 ± 0.39, 7.33 ± 0.07, 6.90± 0.21, and 7.44 ± 0.17 log10 CFU/lung, respectively). Histopathological examination revealed milder inflammatory changes in DQ-113-treated mice than in the mice in the other groups. Of the antibiotics analyzed, the parameters of area under the concentration-time from 0 to 6 h (AUC0-6)/MIC and the time that the AUC0-6 exceeded the MIC were the highest for DQ-113. Our results suggest that DQ-113 is potent and effective for the treatment of hematogenous pulmonary infections caused by MRSA and VISA strains.

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.

scholarly journals Staphylococcus aureus in poultry, with special emphasis on methicillin-resistant strain infection: A comprehensive review from one health perspective

2021 ◽  
pp. 257-267
Author(s):  
Wafaa A. Abd El-Ghany
Keyword(s):  
Staphylococcus Aureus ◽  
Prevention And Control ◽  
Close Contact ◽  
Control Strategies ◽  
Infected Individual ◽  
Surface Proteins ◽  
Methicillin Resistant ◽  
Mrsa Infection ◽  
Mrsa Strains ◽  
And Control

Staphylococcus aureus is a Gram-positive coccus normally present on the skin and internal organs of animals, birds, and humans. Under certain conditions, S. aureus could produce septicemia and affection of the skin, joints, and heart, as well as sepsis and death. The pathogenicity of S. aureus is associated with the presence of some virulent surface proteins and the production of some virulent toxins and enzymes. This pathogen is considered one of the most important and worldwide foodborne causes as it is incriminated in most cases of food poisoning. The hazardous use of antibiotics in the veterinary field leads to the development of multidrug-resistant S. aureus strains that can be transmitted to humans. The incidence of methicillin-resistant S. aureus (MRSA) strains has increased globally. These resistant strains have been detected in live animals, poultry, and humans. In addition, retail animal products, especially those of avian origin, are considered the main source of MRSA strains that can be easily transmitted to humans. MRSA infection is regarded as nosocomial or occupational. Humans get infected with MRSA strains through improper handling or preparation of contaminated animals or poultry carcasses or improper cooking with contaminated meat. Live birds also can transmit MRSA to close-contact workers in poultry farms. Transmission of MRSA infection in hospitals is from an infected individual to a healthy one. Prevention and control of MRSA are based on the application of hygienic measures in farms as well as proper processing, handling, and cooking of retail poultry products. The cooperation between veterinary and human practitioners is a must to avoid the possibility of zoonotic transmission. Accordingly, this review focused on the sources and transmission of MRSA infection, virulence and resistance factors, incidence and prevalence in poultry and different products, antibiotic resistance, and prevention and control strategies.

scholarly journals Outbreak of Invasive Methicillin-ResistantStaphylococcus aureusInfection Associated With Acupuncture and Joint Injection

2008 ◽  
Vol 29 (9) ◽  
pp. 859-865 ◽  
Author(s):  
R. J. Murray ◽  
J. C. Pearson ◽  
G. W. Coombs ◽  
J. P. Flexman ◽  
C. L. Golledge ◽  
...  
Keyword(s):  
Molecular Typing ◽  
Medical Practitioner ◽  
Environmental Sampling ◽  
Joint Injection ◽  
Lower Back ◽  
Sterile Technique ◽  
First Case ◽  
Mrsa Infection ◽  
And Control ◽  
Mrsa Colonization

Objective.To describe an outbreak of invasive methicillin-resistantStaphylococcus aureus(MRSA) infection after percutaneous needle procedures (acupuncture and joint injection) performed by a single medical practitioner.Setting.A medical practitioner's office and 4 hospitals in Perth, Western Australia.Patients.Eight individuals who developed invasive MRSA infection after acupuncture or joint injection performed by the medical practitioner.Methods.We performed a prospective and retrospective outbreak investigation, including MRSA colonization surveillance, environmental sampling for MRSA, and detailed molecular typing of MRSA isolates. We performed an infection control auditofthe medical practitioner's premises and practices and administered MRSA decolonization therapy to the medical practitioner.Results.Eight cases of invasive MRSA infection were identified. Seven cases occurred as a cluster in May 2004; another case (identified retrospectively) occurred approximately 15 months earlier in February 2003. The primary sites of infection were the neck, shoulder, lower back, and hip: 5 patients had septic arthritis and bursitis, and 3 had pyomyositis; 3 patients had bacteremia, including 1 patient with possible endocarditis. The medical practitioner was found to be colonized with the same MRSA clone [ST22-MRSA-IV (EMRSA-15)] at 2 time points: shortly after the first case of infection in March 2003 and again in May 2004. After the medical practitioner's premises and practices were audited and he himself received MRSA decolonization therapy, no further cases were identified.Conclusions.This outbreak most likely resulted from a breakdown in sterile technique during percutaneous needle procedures, resulting in the transmission of MRSA from the medical practitioner to the patients. This report demonstrates the importance of surveillance and molecular typing in the identification and control of outbreaks of MRSA infection.

scholarly journals Molecular characterisation of methicillin-resistant Staphylococcus aureus from chronically colonised cystic fibrosis paediatric patients in Brazil

2020 ◽  
Vol 148 ◽  
Author(s):  
D. C. S. Rodrigues ◽  
D. F. Lima ◽  
R. W. F. Cohen ◽  
E. A. Marques ◽  
R. S. Leão
Keyword(s):  
Cystic Fibrosis ◽  
Staphylococcus Aureus ◽  
Rapid Decline ◽  
High Genetic Diversity ◽  
Methicillin Resistant ◽  
Specialist Centre ◽  
Mrsa Infection ◽  
Resistance Rates ◽  
Panton Valentine Leukocidin ◽  
Chronic Lung Infection

Abstract Persistent methicillin-resistant Staphylococcus aureus (MRSA) infection in cystic fibrosis (CF) patients has been associated with a more rapid decline in lung function, increased hospitalisation and mortality. The aim of this study was to evaluate the clonal relationships among 116 MRSA isolates from 12 chronically colonised CF pediatric patients over a 6-year period in a Rio de Janeiro CF specialist centre. Isolates were characterised by antimicrobial resistance, SCCmec type, presence of Panton-Valentine Leukocidin (PVL) genes and grouped according to DNA macrorestriction profile by pulsed-field gel electrophoresis (PFGE) and spa gene type. High resistance rates were detected for erythromycin (78%) and ciprofloxacin (50%) and SCCmec IV was the most common type (72.4%). Only 8.6% of isolates were PVL positive. High genetic diversity was evident by PFGE (39 pulsotypes) and of nine that were identified spa types, t002 (53.1%) and t539 (14.8%) were the most prevalent. We conclude that the observed homogeneity of spa types within patients over the study period demonstrates the persistence of such strain lineages throughout the course of chronic lung infection.

scholarly journals Antibiotic Resistance Pattern of Staphylococcus Aureus Isolated From Pediatrics With Ocular Infections: A 6-Year Hospital-Based Study in China

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiao-Yu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Ming-Ming Zhou ◽  
Zheng-Yan Zhao
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Resistance Rate ◽  
Resistance Pattern ◽  
Ocular Infection ◽  
Ocular Infections ◽  
Resistance Patterns ◽  
Mrsa Infection ◽  
Resistance Rates ◽  
Antibiotic Resistance Patterns

Staphylococcus aureus (S. aureus) is an important pathogen of ocular infections in pediatrics. The study aimed to identify the prevalence and resistance pattern of S. aureus, especially methicillin-resistant S. aureus (MRSA), in Chinese children with ocular infections. All patients with S. aureus infections were reviewed at a tertiary children's hospital during 2015–2020, and those with ocular infections were investigated for susceptibility results. Of 1,668 S. aureus strains, there were 177 unique isolates from ocular infection. Among them, 45 (25.4%) were MRSA and 132 (74.6%) were methicillin-sensitive S. aureus (MSSA). The proportion of MRSA did not change over time. Most of the strains were obtained from the neonate ward and ophthalmology department (n = 88, 49.7%, and n = 85, 48.0%, respectively), while eye secretion and pus were the main specimen types (n = 128, 72.3%, and n = 37, 20.9%, respectively). MRSA was significantly resistant against penicillin class (97.8%), erythromycin (71.1%), clindamycin (71.1%), and tetracycline (32.1%), with a high multidrug resistance (MDR) rate of 71.1%. However, MRSA was highly sensitive to levofloxacin. Resistance rates against erythromycin and ciprofloxacin as well as MDR percentage all increased among MSSA in children above 1 year of age, ophthalmology department, and outpatient population and decreased in eye secretion specimen. The mean resistance percentage remained stable for MRSA and MSSA during the study period. The survey of ocular S. aureus pathogens in pediatrics and their antibiotic resistance patterns helps in clinical treatment. MRSA with many strains demonstrating MDR is highly prevalent in children with ocular infections in Southeast China. Levofloxacin is an effective topical antibiotic for ocular MRSA infection, while erythromycin has a high resistance rate. The antibiotic resistance patterns of MRSA and MSSA differs and varies by different stratifications. A cautious use of antibiotics should be considered.

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