scholarly journals Optimizing Contact Precautions to Curb the Spread of Antibiotic-resistant Bacteria in Hospitals: A Multicenter Cohort Study to Identify Patient Characteristics and Healthcare Personnel Interactions Associated With Transmission of Methicillin-resistant Staphylococcus aureus

2019 ◽  
Vol 69 (Supplement_3) ◽  
pp. S171-S177 ◽  
Author(s):  
Lyndsay M O’Hara ◽  
David P Calfee ◽  
Loren G Miller ◽  
Lisa Pineles ◽  
Laurence S Magder ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Healthcare Personnel ◽  
Resistant Bacteria ◽  
Bacterial Burden ◽  
Multicenter Cohort Study ◽  
Antibiotic Resistant ◽  
Contact Precautions ◽  
Multicenter Cohort

Abstract Background Healthcare personnel (HCP) acquire antibiotic-resistant bacteria on their gloves and gowns when caring for intensive care unit (ICU) patients. Yet, contact precautions for patients with methicillin-resistant Staphylococcus aureus (MRSA) remains controversial despite existing guidelines. We sought to understand which patients are more likely to transfer MRSA to HCP and to identify which HCP interactions are more likely to lead to glove or gown contamination. Methods This was a prospective, multicenter cohort study of cultured HCP gloves and gowns for MRSA. Samples were obtained from patients’ anterior nares, perianal area, and skin of the chest and arm to assess bacterial burden. Results Among 402 MRSA-colonized patients with 3982 interactions, we found that HCP gloves and gowns were contaminated with MRSA 14.3% and 5.9% of the time, respectively. Contamination of either gloves or gowns occurred in 16.2% of interactions. Contamination was highest among occupational/physical therapists (odds ratio [OR], 6.96; 95% confidence interval [CI], 3.51, 13.79), respiratory therapists (OR, 5.34; 95% CI, 3.04, 9.39), and when any HCP touched the patient (OR, 2.59; 95% CI, 1.04, 6.51). Touching the endotracheal tube (OR, 1.75; 95% CI, 1.38, 2.19), bedding (OR, 1.43; 95% CI, 1.20, 1.70), and bathing (OR, 1.32; 95% CI, 1.01, 1.75) increased the odds of contamination. We found an association between increasing bacterial burden on the patient and HCP glove or gown contamination. Conclusions Gloves and gowns are frequently contaminated with MRSA in the ICU. Hospitals may consider using fewer precautions for low-risk interactions and more for high-risk interactions and personnel.

scholarly journals 1837. Considerations for a Targeted Approach to Contact Precautions for Patients with MRSA in Hospitals: A Multicenter Cohort Study to Identify High-Risk Patient Characteristics and Healthcare Personnel Interactions

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S45-S45
Author(s):  
Lyndsay M O’Hara ◽  
David P Calfee ◽  
Loren G Miller ◽  
Lisa Harris ◽  
Laurence S Magder ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
High Risk Patient ◽  
Healthcare Personnel ◽  
Resistant Bacteria ◽  
Bacterial Burden ◽  
Perianal Area ◽  
Multicenter Cohort Study ◽  
Contact Precautions ◽  
Multicenter Cohort

Abstract Background Healthcare personnel’s (HCP) gloves and gowns are frequently contaminated with antibiotic-resistant bacteria in the intensive care unit (ICU). Guidelines recommend contact precautions for patients with methicillin-resistant Staphylococcus aureus (MRSA); however, this approach remains controversial. This study aimed to identify which patients are more likely to transfer MRSA to HCP gloves or gowns and to identify HCP interactions more likely to lead to glove or gown contamination. Methods In a multicenter cohort study of MRSA colonized patients, we observed HCP–patient interactions and cultured HCP’s gloves and gowns before doffing. We also assessed the association between bacterial burden and contamination by sampling patients’ anterior nares, perianal area, chest, and arm. Results We enrolled 402 MRSA-colonized patients and observed 3,982 HCP interactions. MRSA contamination of HCP gloves and gown occurred in 14.3% and 5.9% of interactions, respectively. Contamination of either gloves or gown occurred in 16.2% of interactions. Occupational/physical therapists had the highest rates of contamination (OR: 6.96 [95% CI: 3.51–13.79]), followed by respiratory therapists (OR: 5.34 [95% CI: 3.04–9.39]) when compared with the “Other” category. Touching the patient was associated with higher contamination (OR: 2.59 [95% CI: 1.04–6.51]) when compared with touching nothing in the room. Touching only the environment was not associated with glove or gown contamination (OR: 1.13 [95% CI: 0.43, 3.00]) when compared with touching nothing. Touching the endotracheal tube (OR: 1.75 [95% CI: 1.38–2.19]), bedding (OR: 1.43 [95% CI: 1.20–1.70]) and bathing a patient (OR: 1.32 [95% CI: 1.01–1.75]) increased odds of contamination when compared with not having such contacts (Figures 1 and 2). We found an association between increasing bacterial burden in the patient’s nares, perianal area, and chest skin and glove or gown contamination. Conclusion Contamination of HCP gloves and gowns with MRSA occurs frequently when caring for ICU patients. We identified interactions that are high-risk for transmission. Hospitals may consider optimizing contact precautions by using less precautions for low-risk interactions and more precautions for high-risk interactions. Disclosures All Authors: No reported Disclosures.

scholarly journals Multicenter Cohort Study of Ceftaroline versus Daptomycin for Treatment of Methicillin-Resistant Staphylococcus aureus Bloodstream Infection

2021 ◽  
Author(s):  
Evan J Zasowski ◽  
Trang D Trinh ◽  
Kimberly C Claeys ◽  
Abdalhamid M Lagnf ◽  
Sahil Bhatia ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Treatment Failure ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Study Drug ◽  
Bloodstream Infections ◽  
Risk Difference ◽  
Multicenter Cohort Study ◽  
Methicillin Resistant ◽  
Composite Failure

Abstract Background Observational data suggest ceftaroline may be effective for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) but comparative data with standard of care are limited. This analysis compares the outcomes of MRSA BSI treated with ceftaroline or daptomycin. Methods Multicenter, retrospective, observational cohort study of adult patients with MRSA BSI from 2010 to 2017. Patients treated with ≥ 72 hours of ceftaroline or daptomycin were included. Those clearing BSI before study drug and those with a pneumonia source were excluded. The primary outcome was composite treatment failure, defined as 30-day mortality, BSI duration ≥ 7 days on study drug, and 60-day MRSA BSI recurrence. Inverse probability of treatment weighted risk difference in composite failure between daptomycin and ceftaroline groups was computed and 15% non-inferiority margin applied. Results Two hundred seventy patients were included; 83 ceftaroline and 187 daptomycin. Ceftaroline was non-inferior to daptomycin with respect to composite failure [39% daptomycin, 32.5% ceftaroline; weighted risk difference (95% CI) 7.0% (-5.0 – 19.0%)]. No differences between treatment groups was observed for 30-day mortality or other secondary efficacy outcomes. Creatine phosphokinase elevation was significantly more common among daptomycin patients (5.3% vs 0%, P = 0.034). Rash was significantly more common among ceftaroline patients (10.8 vs 1.1%, P = 0.001). Conclusions No difference in treatment failure or mortality was observed between MRSA BSI treated with ceftaroline or daptomycin. These data support future study of ceftaroline as a primary MRSA BSI treatment and current use of ceftaroline when an alternative to vancomycin and daptomycin is required.

The impact of methicillin-resistant Staphylococcus aureus on ENT practice

2006 ◽  
Vol 120 (9) ◽  
pp. 713-717 ◽  
Author(s):  
I J Nixon ◽  
B J G Bingham
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Resistant Bacteria ◽  
Antibiotic Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Methicillin Resistant ◽  
The Impact

Antibiotic-resistant bacteria are increasingly common and present a major problem for the modern day ENT surgeon. This article reviews the development of methicillin resistance in Staphylococcus aureus and how it has come to affect ENT practice. We look at the evidence behind measures taken to help deal with methicillin-resistant Staphylococcus aureus (MRSA) and to prevent its spread. We go on to suggest a departmental guideline for infection control, which we hope can be implemented to help deal with the problems created by MRSA.

Indole and Indoline Scaffolds in Antimicrobials: Overview, Synthesis, and Recent Advances in Antimicrobial Research

2020 ◽  
Vol 27 ◽  
Author(s):  
Marcelo J. Nieto ◽  
Hannah K. Lupton
Keyword(s):  
Staphylococcus Aureus ◽  
Antibacterial Activity ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Antibacterial Compounds ◽  
Disease States ◽  
New Antibiotics ◽  
Approved Drugs ◽  
Fda Approved Drugs

: In our current society, a pandemic of antibiotic-resistant infectious diseases is an ever-growing threat. The need for new antibiotics and ways to combat antibiotic resistance is glaring. This review will focus on two different privileged scaffolds, the indole and the indoline, as useful nuclei for novel antibacterial compounds. The indole, a moiety found in numerous approved drugs for many disease states, has recently been studied for its usefulness as a scaffold for compounds that have activity against antibiotic-resistant bacteria, especially against methicillin-resistant Staphylococcus aureus (MRSA). The indoline is a scaffold with significantly less historical studies and FDA-approved drugs and it has attracted new interest in drug design and development. In recent years, indoline-containing compounds have been shown to have antibacterial activity as well as activity as a resistance-modifying agent (RMA), which act to improve the effectiveness of current antibiotic therapies that have known resistance.

Particle-based immunochemical separation of methicillin resistant Staphylococcus aureus with indirect electrochemical detection of labeling oligonucleotides

2016 ◽  
Vol 8 (25) ◽  
pp. 5123-5128 ◽  
Author(s):  
K. Cihalova ◽  
D. Hegerova ◽  
S. Dostalova ◽  
P. Jelinkova ◽  
L. Krejcova ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Early Detection ◽  
Electrochemical Detection ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Resistant Bacteria ◽  
Antibiotic Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Methicillin Resistant ◽  
Timely Treatment

Early detection of antibiotic-resistant bacteria causing inflammation in patients is a key for an appropriate and timely treatment.

Hyaluronidase-responsive phototheranostic nanoagents for fluorescence imaging and photothermal/photodynamic therapy of methicillin-resistant Staphylococcus aureus infections

2021 ◽  
Author(s):  
Lihui Yuwen ◽  
Qiu Qiu ◽  
Wei-Jun Xiu ◽  
Kaili Yang ◽  
Yuqing Li ◽  
...  
Keyword(s):  
Public Health ◽  
Staphylococcus Aureus ◽  
Photodynamic Therapy ◽  
Infectious Diseases ◽  
Effective Treatment ◽  
Bacterial Infections ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Detection Methods ◽  
Resistant Bacteria ◽  
Antibiotic Resistant

Infectious diseases associated with antibiotic-resistant bacteria are ever-growing threats to public health. Effective treatment and detection methods of bacterial infections are in urgent demand. Herein, novel phototheranostic nanoagents (MoS2@HA-Ce6 nanosheets,...

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