Comparative Cost of Selective Screening To Prevent Transmission of Methicillin-ResistantStaphylococcus aureus(MRSA), Compared With the Attributable Costs of MRSA Infection

The annual cost of a screening program to detect methicillin-resistantStaphylococcus aureus(MRSA) in a teaching hospital in Spain was €10,261. The average cost per MRSA infection was €2,730; therefore, the cost of the program would be covered if it only prevented 4 infections per year (11% of the total number of MRSA infections at our hospital).

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Methicillin-Resistant Staphylococcus aureus (MRSA) Infection of Diabetic Foot Ulcers at a Tertiary Care Hospital in Accra, Ghana

Pathogens ◽

10.3390/pathogens10080937 ◽

2021 ◽

Vol 10 (8) ◽

pp. 937

Author(s):

Ramzy B. Anafo ◽

Yacoba Atiase ◽

Nicholas T. K. D. Dayie ◽

Fleischer C. N. Kotey ◽

Patience B. Tetteh-Quarcoo ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Multidrug Resistance ◽

Teaching Hospital ◽

Diabetic Foot ◽

Foot Ulcer ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Coagulase Negative Staphylococci ◽

Methicillin Resistant ◽

Mrsa Infection

Aim: This study investigated the spectrum of bacteria infecting the ulcers of individuals with diabetes at the Korle Bu Teaching Hospital in Accra, Ghana, focusing on Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA), with respect to their prevalence, factors predisposing to their infection of the ulcers, and antimicrobial resistance patterns. Methodology: This cross-sectional study was conducted at The Ulcer Clinic, Department of Surgery, Korle Bu Teaching Hospital, involving 100 diabetic foot ulcer patients. The ulcer of each study participant was swabbed and cultured bacteriologically, following standard procedures. Antimicrobial susceptibility testing was done for all S. aureus isolated, using the Kirby-Bauer method. Results: In total, 96% of the participants had their ulcers infected—32.3% (n = 31) of these had their ulcers infected with one bacterium, 47.9% (n = 46) with two bacteria, 18.8% (n = 18) with three bacteria, and 1.0% (n = 1) with four bacteria. The prevalence of S. aureus and MRSA were 19% and 6%, respectively. The distribution of the other bacteria was as follows: coagulase-negative Staphylococci (CoNS) (54%), Escherichia coli (24%), Pseudomonas spp. (19%), Citrobacter koseri and Morganella morgana (12% each), Klebsiella oxytoca (11%), Proteus vulgaris (8%), Enterococcus spp. (6%), Klebsiella pneumoniae (5%), Proteus mirabilis and Enterobacter spp. (4%), Klebsiella spp. (2%), and Streptococcus spp. (1%). The resistance rates of S. aureus decreased across penicillin (100%, n = 19), tetracycline (47.4%, n = 9), cotrimoxazole (42.1%, n = 8), cefoxitin (31.6%, n = 6), erythromycin and clindamycin (26.3% each, n = 5), norfloxacin and gentamicin (15.8% each, n = 3), rifampicin (10.5%, n = 2), linezolid (5.3%, n = 1), and fusidic acid (0.0%, n = 0). The proportion of multidrug resistance was 47.4% (n = 9). Except for foot ulcer infection with coagulase-negative Staphylococci, which was protective of S. aureus infection of the ulcers (OR = 0.029, p = 0.001, 95% CI = 0.004–0.231), no predictor of S. aureus, MRSA, or polymicrobial ulcer infection was identified. Conclusions: The prevalence of S. aureus and MRSA infection of the diabetic foot ulcers were high, but lower than those of the predominant infector, coagulase-negative Staphylococci and the next highest infecting agent, E. coli. Diabetic foot ulcers’ infection with coagulase-negative Staphylococci protected against their infection with S. aureus. The prevalence of multidrug resistance was high, highlighting the need to further intensify antimicrobial stewardship programmes.

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Cost-Effective Eradication of an Outbreak of Methicillin-Resistant Staphylococcus aureus in a Community Teaching Hospital

Infection Control and Hospital Epidemiology ◽

10.1086/645848 ◽

1988 ◽

Vol 9 (6) ◽

pp. 255-260 ◽

Cited By ~ 22

Author(s):

Nalini Rao ◽

Sharon Jacobs ◽

Linda Joyce

Keyword(s):

Staphylococcus Aureus ◽

Teaching Hospital ◽

Cost Effective ◽

Methicillin Resistant ◽

Critical Care Units ◽

Outbreak Period ◽

Surgical Teaching ◽

The Cost ◽

Community Teaching ◽

Microbiological Surveillance

AbstractDuring an eight-month period, 25 hospitalized patients became infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) in a 464-bed acute care, medical-surgical teaching hospital. There were only five cases during the eight months prior to the outbreak period (P < 0.0001). Initial measures, including category-specific isolation and education, did not limit the spread of the outbreak of a strain of MRSA. This prompted institution of additional measures including (1) strict isolation of all infected and colonized cases; (2) prospective microbiological surveillance to detect additional cases; (3) multiple site cultures of identified cases to determine the extent of colonization; (4) employee and environment surveillance; (5) antibiotic decolonization of patients and employees; and (6) educational efforts. The highest number of personnel carriers were noted in one of the critical care units where most of the cases occurred. The decolonization protocol was 100% effective for personnel carriers. The incidence of nosocomial cases of MRSA fell to zero in the five months following the implementation of the strategy. The cost of the entire eradication process was approximately half that of treating a single MRSA bacteremia.

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Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection and the molecular characteristics of MRSA bacteraemia over a two-year period in a tertiary teaching hospital in Malaysia

BMC Infectious Diseases ◽

10.1186/s12879-017-2384-y ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 25

Author(s):

Pik San Sit ◽

Cindy Shuan Ju Teh ◽

Nuryana Idris ◽

I-Ching Sam ◽

Sharifah Faridah Syed Omar ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Teaching Hospital ◽

Methicillin Resistant Staphylococcus Aureus ◽

Molecular Characteristics ◽

Methicillin Resistant ◽

Tertiary Teaching ◽

Tertiary Teaching Hospital ◽

Mrsa Infection

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Methicillin-Resistant Staphylococcus aureus spa Type t002 Outbreak in Horses and Staff at a Veterinary Teaching Hospital after Its Presumed Introduction by a Veterinarian

Journal of Clinical Microbiology ◽

10.1128/jcm.00090-15 ◽

2015 ◽

Vol 53 (9) ◽

pp. 2827-2831 ◽

Cited By ~ 7

Author(s):

Amir Steinman ◽

Samira Masarwa ◽

Sharon Tirosh-Levy ◽

Dan Gleser ◽

Gal Kelmer ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Teaching Hospital ◽

Large Animal ◽

Prevalence Survey ◽

Methicillin Resistant ◽

Content Type ◽

Staff Members ◽

Cross Transmission ◽

Mrsa Infection ◽

Mrsa Strains

Methicillin-resistantStaphylococcus aureus(MRSA) infection and colonization, involving MRSA strains which differ from common human health care-associated clones, have become serious emerging conditions in equine veterinary hospitals. In 2010, MRSAspatype t535 caused an outbreak involving both horses and personnel in a veterinary teaching hospital in Israel. Since then, surveillance continued, and occasional MRSA isolation occurred. Two years later, MRSA of anotherspatype, t002, was isolated from a veterinarian and, 3 weeks later, from a horse. The appearance ofspatype t002, a common clone in human medicine in Israel, among both personnel and horses, prompted a point-prevalence survey of hospital personnel and hospitalized horses. Fifty-nine staff members (n= 16 equine;n= 43, other) and 14 horses were screened. Ten of 59 staff members (16.9%) and 7 of 14 horses (50%) were MRSA carriers. Among the staff, 44% of large animal department (LAD) personnel, compared with only 7% of non-LAD personnel, were carriers. Isolates from all horses and from 9 of 10 personnel were found to be of MRSAspatype t002. This clone was later isolated from an infected postoperative wound in a hospitalized horse. Measures were taken to contain transmission between horses and personnel, as was done in the previous outbreak, resulting in reduction of transmission and, finally, cessation of cross-transmission between horses and personnel.

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Prevalence of Methicillin-Resistant Staphylococcus aureus in Elective Surgical Patients at a Public Teaching Hospital: An Analysis of 1039 Patients

The American Surgeon ◽

10.1177/000313481207801019 ◽

2012 ◽

Vol 78 (10) ◽

pp. 1096-1099 ◽

Cited By ~ 5

Author(s):

Jesse Manunga ◽

Jemi Olak ◽

Carmen Rivera ◽

Maureen Martin

Keyword(s):

Staphylococcus Aureus ◽

Methicillin Resistant Staphylococcus Aureus ◽

Elective Surgery ◽

Surgical Site Infections ◽

Surgical Patients ◽

Oral Swab ◽

Methicillin Resistant ◽

Mrsa Infection ◽

The Cost

Methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly common cause of postoperative surgical site infections (SSIs). It is unclear, however, whether asymptomatic colonization or nosocomial acquisition of MRSA results in postoperative SSI. We conducted a retrospective review of patients screened for MRSA between May 2008 and October 2010 at our institution. End points included rates of MRSA infection, SSI, and the cost of routine MRSA screening of patients undergoing elective surgery. Of the 1039 patients screened preoperatively, 48 (4.6%) tested positive for MRSA by nasal or oral swab, whereas 991 (95.4%) tested negative. Forty-five (93.8%) MRSA-positive patients received vancomycin or linezolid and three (6.25%) received cefazolin peri-operatively. Three (6.25%) MRSA-positive patients developed postoperative SSIs. Two required rehospitalization for intravenous antimicrobials, whereas a third patient required removal of infected abdominal mesh. Twenty (2.02%) MRSA-negative patients and four (5.26%) unscreened patients developed non-MRSA SSIs. Regardless of MRSA status, none of 609 patients who had a laparoscopic procedure or inguinal hernia repair developed SSI. Twenty-two patients needed to be screened to obtain one positive test. The role of MRSA screening and longer perioperative coverage for MRSA-positive patients undergoing complex elective procedures remains to be determined.

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A Neonatal Specialist With Recurrent Methicillin-Resistant Staphylococcus aureus (MRSA) Carriage Implicated in the Transmission of MRSA to Newborns

Infection Control and Hospital Epidemiology ◽

10.1086/513616 ◽

2007 ◽

Vol 28 (05) ◽

pp. 625-628 ◽

Cited By ~ 14

Author(s):

M. Méan ◽

M. R. Mallaret ◽

P Andrini ◽

C. Recule ◽

T. Debillon ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Teaching Hospital ◽

Methicillin Resistant Staphylococcus Aureus ◽

Neonatal Unit ◽

Methicillin Resistant ◽

Mrsa Infection

This study reports an investigation of outbreaks of methicillin-resistantStaphylococcus aureus(MRSA) infection and colonization involving 17 newborns in the neonatal unit of a teaching hospital. A neonatal specialist colonized with MRSA that eventually became mupirocin-resistant was implicated as a recurrent source of transmission of MRSA to newborns.

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