Residential Proximity to Large Numbers of Swine in Feeding Operations Is Associated with Increased Risk of Methicillin-Resistant Staphylococcus aureus Colonization at Time of Hospital Admission in Rural Iowa Veterans

2014 ◽  
Vol 35 (2) ◽  
pp. 190-192 ◽  
Author(s):  
Margaret Carrel ◽  
Marin L. Schweizer ◽  
Mary Vaughan Sarrazin ◽  
Tara C. Smith ◽  
Eli N. Perencevich
Keyword(s):  
Staphylococcus Aureus ◽  
Relative Risk ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Residential Proximity ◽  
Large Numbers ◽  
Increased Risk ◽  
Mrsa Colonization

Among 1,036 patients, residential proximity within 1 mile of large swine facilities was associated with nearly double the risk of methicillin-resistant Staphylococcus aureus (MRSA) colonization at admission (relative risk, 1.8786 [95% confidence interval, 1.0928-3.2289]; P = .0239) and, after controlling for multiple admissions and age, was associated with 1.2nearly triple the odds of MRSA colonization (odds ratio, 2.76 [95% confidence interval, 1.2728-5.9875]; P = .0101).

scholarly journals Association between Methicillin-Resistant Staphylococcus aureus Colonization and Infection May Not Differ by Age Group

2013 ◽  
Vol 34 (1) ◽  
pp. 93-95 ◽  
Author(s):  
Adebola O. Ajao ◽  
Anthony D. Harris ◽  
J. Kristie Johnson ◽  
Mary-Claire Roghmann ◽  
Eli N. Perencevich ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Age Group ◽  
Subsequent Infection ◽  
Methicillin Resistant ◽  
Mrsa Colonization

We assessed whether age modified the association between methicillin-resistant Staphylococcus aureus (MRSA) anterior nares colonization and subsequent infection. Among 7,405 patients (9,511 admissions), MRSA colonization was significantly associated with infection (adjusted odds ratio, 13.7 [95% confidence interval, 7.325.7]) but did not differ significantly by age group.

scholarly journals Methicillin-resistant Staphylococcus aureus among healthcare workers: screening, risk factors and treatment

2021 ◽  
Author(s):  
Rahmathulla Safiyul Rahman ◽  
Badr Mohammed Beyari ◽  
Kawlah Essam Samarin ◽  
Khalid Mohammed Alamri ◽  
Marwan Abdulaziz Bader ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Healthcare Workers ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Skin Diseases ◽  
Bloodstream Infections ◽  
Methicillin Resistant ◽  
Increased Risk ◽  
Wide Range ◽  
Mrsa Colonization

Methicillin-resistant Staphylococcus aureus (MRSA) is a common pathogen of clinical significance within the community and healthcare settings. It has been reported with a variety of infections, including endocarditis, bloodstream infections, pneumonia, joint and bone infections, and soft tissue and skin infections. Although many efforts have been exerted to eradicate the rates of infections and studies have reported a decreasing pattern in the prevalence rates over the years, it has been demonstrated that MRSA represents a significant challenge to the healthcare systems and the affected patients. In this literature review, we have provided a discussion regarding the risk factors, screening, and treatment of MRSA among healthcare workers (HCWs) based on the evidence obtained from the current relevant studies in the literature. HCWs are at increased risk of MRSA colonization, and many risk factors have been identified. These mainly include poor hygiene practices, chronic skin diseases, and having a history of working in an MRSA-endemic country. Decolonization practices are the main line of treatment of MRSA colonization among HCWs because antibiotic therapy is usually of limited use because of the increasing resistance to a wide range of antibiotics. Applying adequate interventions as taking care of hand hygiene and using alcohol-based disinfectants is recommended to achieve better outcomes. Increasing awareness among HCWs is also a potential approach to achieve better management.

scholarly journals Clinical Utility of Infection Control Documentation of Prior Methicillin-Resistant Staphylococcus aureus Colonization or Infection for Optimization of Empirical Antibiotic Therapy

2008 ◽  
Vol 29 (10) ◽  
pp. 972-974 ◽  
Author(s):  
Marin L. Schweizer ◽  
Jon P. Furuno ◽  
Anthony D. Harris ◽  
Jessina C. McGregor ◽  
Kerri A. Thom ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Antibiotic Therapy ◽  
Odds Ratio ◽  
Clinical Utility ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Empirical Therapy ◽  
Empirical Antibiotic Therapy ◽  
Methicillin Resistant ◽  
Mrsa Colonization

This 5-year study of 25,378 hospitalizations measured the utility of infection control documentation of prior methicillin-resistant Staphylococcus aureus (MRSA) colonization or infection for the optimization of empirical antibiotic therapy. Documented prior MRSA colonization or infection was predictive of subsequent MRSA infections (odds ratio, 4.05). Physicians appear to use this documentation when prescribing empirical therapy for suspected bacteremia.

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.

Assessment of Mupirocin Resistance among Clinical Isolates of Methicillin Resistant Staphylococcus aureus

2021 ◽  
Vol 30 (1) ◽  
pp. 109-114
Author(s):  
Nancy M. Attia ◽  
Abeer Abd El Rahim Ghazal ◽  
Omnia M. Khaleel ◽  
Ahmed Gaballah
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Methicillin Resistant ◽  
Mupirocin Resistance ◽  
High Level ◽  
Research Institute Hospital ◽  
Low Prevalence ◽  
Mrsa Colonization

Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization is considered a major risk factor for nosocomial infections and its decolonization has reduced these infections. Mupirocin (MUP) is the topical antibiotic of choice for decolonization. MUP decolonization failure is attributed to MUP resistance. Objective: The aim of the current study is to assess MUP resistance among MRSA isolates phenotypically and genotypically. Methodology: Fifty MRSA isolates were identified in Microbiology Department in the Medical Research Institute hospital, Alexandria University. Antibiotic susceptibility to different classes of antibiotics by disk diffusion method was done. MUP minimum inhibitory concentration (MIC) was determined phenotypically by MUP Ezy MIC™ Strips. MUP resistance was determined genetically by multiplex PCR detection of mupA and mupB. Results: Of all MRSA isolates, 6% exhibited high level and none showed low level MUP resistance. Only mupA was detected in all resistant isolates. Conclusion: Despite low prevalence of MUP resistance, it is appropriate to test MUP resistance prior nasal decolonization

Increasing Prevalence of Methicillin-Resistant Staphylococcus aureus in the United States

1990 ◽  
Vol 11 (12) ◽  
pp. 639-642 ◽  
Author(s):  
John M. Boyce
Keyword(s):  
United States ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
The United States ◽  
University Hospitals ◽  
Methicillin Resistant ◽  
Large Numbers ◽  
Tertiary Care Centers ◽  
Community Teaching

AbstractIn the period 1975 to 1981, methicillin-resistant Staphylococcus aureus (MRSA) emerged as an important nosocomial pathogen in tertiary care centers in the United States. To determine if the prevalence of this organism has continued to increase, a questionnaire was sent to hospital epidemiologists in 360 acute care hospitals. A total of 256 (71%) of the 360 individuals responded. Overall, 97% (246/256) of responding hospitals reported having patients with MRSA in the period 1987 through 1989. Respondents in 217 hospitals provided estimates of the number of cases seen in 1987, 1988 and 1989. The percentage of respondents reporting one or more patients with MRSA increased from 88% in 1987 to 96.3% in 1989 (p = .0008). The percent of respondents reporting large numbers (≥50) of cases per year increased from 18% in 1987 to 32% in 1989 (p = .0006). Increasing frequency of large outbreaks was observed in community, community-teaching, federal, municipal and university hospitals.

scholarly journals Frequent Methicillin-Resistant Staphylococcus aureus Introductions Into an Inner-city Jail: Indications of Community Transmission Networks

2019 ◽  
Vol 71 (2) ◽  
pp. 323-331 ◽  
Author(s):  
Kyle J Popovich ◽  
Evan S Snitkin ◽  
Chad Zawitz ◽  
Alla Aroutcheva ◽  
Darjai Payne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Drug Use ◽  
Molecular Epidemiology ◽  
Skin Infection ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Transmission Networks ◽  
Methicillin Resistant ◽  
Community Transmission ◽  
Mrsa Colonization

Abstract Background Jails may facilitate spread of methicillin-resistant Staphylococcus aureus (MRSA) in urban areas. We examined MRSA colonization upon entrance to a large urban jail to determine if there are MRSA transmission networks preceding incarceration. Methods Males incarcerated in Cook County Jail (Chicago) were enrolled, with enrichment for people living with human immunodeficiency virus (PLHIV), within 72 hours of intake. Surveillance cultures assessed prevalence of MRSA colonization. Whole-genome sequencing (WGS) identified preincarceration transmission networks. We examined methicillin-resistant Staphylococcus aureus (MRSA) isolates to determine if there are transmission networks that precede incarceration. A large proportion of individuals enter jail colonized with MRSA. Molecular epidemiology and colonization risk factors provide clues to community reservoirs for MRSA. Results There were 718 individuals (800 incarcerations) enrolled; 58% were PLHIV. The prevalence of MRSA colonization at intake was 19%. In multivariate analysis, methamphetamine use, unstable housing, current/recent skin infection, and recent injection drug use were predictors of MRSA. Among PLHIV, recent injection drug use, current skin infection, and HIV care at outpatient clinic A that emphasizes comprehensive care to the lesbian, gay, bisexual, transgender community were predictors of MRSA. Fourteen (45%) of 31 detainees with care at clinic A had colonization. WGS revealed that this prevalence was not due to clonal spread in clinic but rather to an intermingling of distinct community transmission networks. In contrast, genomic analysis supported spread of USA500 strains within a network. Members of this USA500 network were more likely to be PLHIV (P &lt; .01), men who have sex with men (P &lt; .001), and methamphetamine users (P &lt; .001). Conclusions A large proportion of individuals enter jail colonized with MRSA. Molecular epidemiology and colonization risk factors provide clues to identify colonized detainees entering jail and potential community reservoirs of MRSA.

Prevalence of multidrug-resistant organisms on palliative care patients in a university hospital–bound palliative care unit: A prospective cohort analysis

2020 ◽  
Vol 34 (6) ◽  
pp. 776-783 ◽  
Author(s):  
Tobias Georg Strapatsas ◽  
Viola Simons ◽  
Beniam Ghebremedhin ◽  
Parviz Ahmad-Nejad ◽  
Oliver Schmalz
Keyword(s):  
Staphylococcus Aureus ◽  
Palliative Care ◽  
Confidence Interval ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Cohort Analysis ◽  
Multidrug Resistant ◽  
Interquartile Range ◽  
University Hospital ◽  
Methicillin Resistant ◽  
Multidrug Resistant Organisms

Background: Multidrug-resistant organisms are a growing challenge and burden to patient care. To date, there are only data concerning the prevalence of methicillin-resistant Staphylococcus aureus infections. Thus, numbers of other multidrug-resistant organisms can only be extrapolated and inferred from more or less comparable cohorts. Aim: To evaluate the prevalence of multidrug-resistant organisms on palliative care in-patients. Design: A prospective cohort analysis Setting/participants: A University Hospital–bound palliative care unit, in which all patients admitted to the unit were screened for inclusion. Results: In total, 304 patients were included in this study. The prevalence for methicillin-resistant Staphylococcus aureus of 5.2% (95% confidence interval: 2.9%–8.4%), for vancomycin-resistant Enterococcus faecium of 10.5% (95% confidence interval: 7.2%–14.8%), for Ciprofloxacin-resistant-extended spectrum beta-lactamases isolates of 5.8% (95% confidence interval: 3.4%–9.3%) and Ciprofloxacin-resistant Carbapenem-resistant Gram-negative bacteria of 0.3% (95% confidence interval: 0%–1.3%) was calculated. Except for methicillin-resistant Staphylococcus aureus, patients carrying a multidrug-resistant organism had a significant longer duration of hospitalization. Median length of stay was 12 days (interquartile range: 14.5, no multidrug-resistant organisms), 14.5 days (interquartile range: 15, methicillin-resistant Staphylococcus aureus), 21 days (interquartile range: 16.5, vancomycin-resistant enterococci), 22 days (interquartile range: 20.75, Ciprofloxacin-resistant-extended spectrum beta-lactamases) and 32 days (interquartile range: 22.00) for patients carrying two organisms. Conclusion: There is a high prevalence of all multidrug-resistant organisms within the hospitalized palliative care patients. However, the multidrug-resistant organisms do not seem to impact the survival within this cohort. Further studies should evaluate additional end-points, for example, quality of life, which are of special interest in this cohort.

scholarly journals What Is the Primary Driver of Preoperative Vancomycin Use? It’s Not Methicillin-resistant Staphylococcus aureus—or Allergy

2020 ◽  
Vol 71 (10) ◽  
pp. 2732-2735
Author(s):  
Judith M Strymish ◽  
William O’ Brien ◽  
Kamal Itani ◽  
Kalpana Gupta ◽  
Westyn Branch-Elliman
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Veterans Affairs ◽  
Common Reason ◽  
Surgical Prophylaxis ◽  
Surgical Specialty ◽  
Methicillin Resistant ◽  
Primary Driver ◽  
Mrsa Colonization

Abstract Factors driving vancomycin surgical prophylaxis are poorly understood. In a national Veterans Affairs cohort with manually validated data, surgical specialty (cardiac, orthopedics) and perception of high facility methicillin-resistant Staphylococcus aureus (MRSA) prevalence—not MRSA colonization—were the primary drivers of prescribing. A β-lactam allergy was the second most common reason. These data may inform perioperative stewardship.

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