scholarly journals Prevalence and molecular epidemiology of methicillin-resistant Staphylococcus aureus colonization with and without methicillin-resistant coagulase-negative Staphylococci in HIV-infected patients

2020 ◽  
Author(s):  
Ying Li ◽  
Jialing Lin ◽  
Linghua Li ◽  
Weiping Cai ◽  
Yingying Wang ◽  
...  

Abstract Background The global prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in human immunodeficiency virus (HIV)-infected patients is increasing, but data about it was limited in mainland China. This study aims to investigate the epidemiology of MRSA nasal colonization among HIV-infected patients in mainland China and also evaluate the impact of methicillin-resistant coagulase-negative Staphylococci (MRCoNS). Methods This cross-sectional study was designed to collect nasal samples and individual information for HIV-infected participants. Risk factors and phenotypic and molecular characteristics among those with MRSA colonization comparing those with and without MRCoNS co-colonization were analyzed.Results We found 119 (11.89%) out of 1001 HIV-infected patients were colonized with MRSA, including 41 (4.10%) with MRCoNS and 78 (7.79%) without MRCoNS. Having a history of respiratory tract infection in the previous 6 months(adjusted OR=1.64, 95% CI: 1.04-2.57) and male gender (aOR=3.92, 95% CI: 1.20-12.85) were risk factors for the overall MRSA and MRSA without MRCoNS colonization, respectively. No risk factor was associated with co-colonization of MRSA and MRCoNS. The proportions of antibiotic resistance and toxin genes as well as the distribution of molecular types for MRSA isolates were equivalent between subjects with and without MRCoNS isolates (P-value ≥0.05). Conclusions HIV-infected patients remain a highly vulnerable population for MRSA colonization, and men and prior history of respiratory tract infection are risk factors. Risk factors and phenotypic and molecular characteristics of MRSA colonization were not affected by co-colonizing with MRCoNS.

1970 ◽  
Vol 29 (4) ◽  
Author(s):  
Kemi Elizabeth Tuta ◽  
Abiola Olukemi Okesola ◽  
Chukwuma David Umeokonkwo

BACKGROUND: Nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization is of public health concern due to increased risk of developing invasive infections and the therapeutic challenges. This concern is more among the vulnerable group. We determined the prevalence and associated risk factors of MRSA nasal carriage among children in a tertiary hospital in Nigeria.METHOD: We conducted a hospital-based, cross-sectional study among 300 children attending the outpatient clinic of a tertiary hospital recruited through systematic sampling technique. An interviewer-administered, structured questionnaire was used to obtain sociodemographic characteristics and exposure factors. Nasal swabs samples were collected and inoculated on mannitol salt agar and subcultured on nutrient agar to isolate Staphylococcus aureus. We used the conventional Polymerase Chain Reaction (PCR) technique to detect the presence of mecA gene for MRSA. We calculated the prevalence, prevalence odds ratio to determine risk factors for MRSA acquisition at 5% level of significance.RESULTS: The median age was 1.7 years (6 months-16 years). Males accounted for 60.7%, and 75% of the participants were under 5 years. Staphylococcus aureus colonization was found in 36.3% of the participants while 5.3% of the participants had MRSA identified by detecting the mecA gene. History of recent surgery in the last six months was the only independent predictor of nasal MRSA colonization among the participants (aOR=12.5; 95%CI: 2.7-50.0.)CONCLUSION: The high prevalence of MRSA colonization observed among the children in this study suggests the need to consider screening children with history of previous surgery as infection control and prevention intervention for MRSA.


Author(s):  
Beladenta Amalia ◽  
Yulia Rosa Saharman

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the Multidrug-resistant organisms (MDRO) which has been quite an endemic in many healthcare facilities, especially in the Intensive Care Unite (ICU) of hospitals. History of patients’ hospitalization before ICU admission has been considered to be one of the risk factors for MRSA colonization in patients. Problems arised after knowing that ICU patients with MRSA colonization are at high risk of MRSA infection. Therefore, we require data of MRSA colonization associated history of patients’ hospitalization before ICU admission in hopes that the incidence of MRSA colonization in Indonesia hospitals can be reduced. This is an analytical cross sectional study using secondary data results from microbiological examination of swabs (nose, underarms, and rectum) and medical records of 109 patients from the Central ICU RSCM on January 2011 until August 2011. Sample selection was conducted by consecutive sampling. Microbiological examination results which were used in this study were the results of MRSA resistance test both in patients who had history of hospitalization before ICU admission and those who did not. Data was analyzed using Chi-squared test. The result of comparing data between the proportion of patients with positive MRSA colonization and had history of hospitalization to the proportion of patients with positive MRSA colonization but did not have history of hospitalization was PR (prevalence ratio)=1,206 with significance value p=0,307 and CI95% -3,087; 5,499. This suggests that history of patients’ hospitalization before ICU admission was not the only factor to affect MRSA colonization. Antibiotic administrations and prior contact with MRSA carrier in the community might be other risk factors which may obscure this result. It indicates that hospitals should conduct routine MRSA colonization screening to all patients, regardless of their history of hospitalization, as a standard precaution for infection control.


2019 ◽  
Vol 71 (2) ◽  
pp. 323-331 ◽  
Author(s):  
Kyle J Popovich ◽  
Evan S Snitkin ◽  
Chad Zawitz ◽  
Alla Aroutcheva ◽  
Darjai Payne ◽  
...  

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 < .01), men who have sex with men (P < .001), and methamphetamine users (P < .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.


2015 ◽  
Vol 144 (5) ◽  
pp. 1014-1017 ◽  
Author(s):  
P. BAKER ◽  
B. COHEN ◽  
J. LIU ◽  
E. LARSON

SUMMARYThis study aims to describe changes in incidence and risk factors for community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) infections upon admission to two New York City hospitals from 2006 to 2012. We examined the first hospitalization for adult patients using electronic health record and administrative data and determined the annual incidence/1000 admissions of total S. aureus, total MRSA, and CA-MRSA (within 48 h of admission) in clinical specimens over the study period. Logistic regression was used to identify factors associated with CA-MRSA in 2006 and 2012. In 137 350 admissions, the incidence of S. aureus, MRSA, and CA-MRSA/1000 admissions were 15·6, 7·0, and 3·5, respectively. The total S. aureus and MRSA isolations decreased significantly over the study period (27% and 25%, respectively) while CA-MRSA incidence was unchanged. CA-MRSA increased as a proportion of all MRSA between 2006 (46%) and 2012 (62%), and was most frequently isolated from respiratory (1·5/1000) and blood (0·7/1000) cultures. Logistic regression analysis of factors associated with isolation of CA-MRSA showed that age ⩾65 years [odds ratio (OR) 2·3, 95% confidence interval (CI) 1·2–4·5], male gender (OR 1·8, 95% CI 1·2–2·8) and history of renal failure (OR 2·6, 95% CI 1·6–4·2) were significant predictors of infection in 2006. No predictors were identified in 2012.


2007 ◽  
Vol 18 (8) ◽  
pp. 521-526 ◽  
Author(s):  
Nancy F Crum-Cianflone ◽  
Alina A Burgi ◽  
Braden R Hale

Community-acquired (CA) methicillin-resistant Staphylococcus aureus (MRSA) rates have rapidly increased in the general population; however, little data on recent incidence rates and risk factors of CA-MRSA infections among HIV patients appear in the literature. A retrospective study was conducted from 1993 through 2005 among patients at a large HIV clinic. Trends in CA-MRSA infection incidence rates, clinical characteristics and risk factors for CA-MRSA were evaluated. Seven percent of our cohort developed a CA-MRSA infection during the study period. The rate of CA-MRSA infections among HIV-infected population significantly increased since 2003, with an incidence of 40.3 cases/1000 person-years in 2005, which was 18-fold higher than the general population served at our facility. In all, 90% of infections were skin/soft tissue infections with a predilection for buttock or scrotal abscess formation; 21% of patients experienced a recurrent infection. Risk factors included a low CD4 count at the time of infection (odds ratio [OR] per 100 CD4 cells 0.84, P = 0.03), high maximum log10 HIV viral load (OR 4.54, P<0.001), recent use of β-lactam antibiotics (OR 6.0 for receipt of two prescriptions, P<0.001) and a history of syphilis (OR 4.55, P = 0.01). No patient receiving trimethoprim-sulfamethoxazole prophylaxis developed a CA-MRSA infection. Over the study period, CA-MRSA accounted for an increasing percentage of positive wound cultures and Staphylococcus aureus isolates, 37% and 65%, respectively, during 2005. In conclusion, CA-MRSA infections have rapidly increased among HIV-infected patients, a group which has a higher rate of these infections than the general population. Risk factors for CA-MRSA among HIV-infected patients include low current CD4 cell count, recent β-lactam antibiotic use and potentially high-risk sexual activity as demonstrated by a history of syphilis infection.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P173-P173
Author(s):  
Brian Nicholas ◽  
Geeta Bhargave ◽  
Ryan Heffelfinger ◽  
Marc R Rosen ◽  
Edmund A Pribitkin

Objectives 1) Understand the extent of methicillin-resistant Staphylococcus aureus among those undergoing intranasal surgery. 2) Be able to describe potential risk factors for MRSA colonization. The purpose of this study is to outline a prevalance of MRSA colonization among those undergoing inranasal surgery, with an exploration of potential risk factors for colonization. Methods Patients undergoing intranasal surgery (endoscopic sinus surgery, rhinoplasty, septoplasty, etc) at a tertiary care medical center had preoperative nasal swab cultures. The primary endpoint was positive culture of methicillin-resistant Staphylococcus aureus (MRSA). Patient demographic information was also collected to ascertain potential risk factors for colonization of MRSA. Results Early results have demonstrated that the prevalence of MRSA in patients is less than the reported prevalence in hospital inpatient populations. Of the initial 25 patients enrolled in this study, none were shown to be colonized with methicillin-resistant Staphylococcus aureus (0/25), with 1 patient having reported a history of MRSA infection (4%). Conclusions Preliminary data suggests that the prevalence of methicillin-resistant Staphylococcus aureus among patients undergoing intranasal surgery is less than the prevalence of inpatient populations as reported in several previous studies. While preliminary data suggests a potential decreased prevalence of MRSA in this population, a much larger sample of patients is needed to make a more definitive statement. In the coming weeks and months, as more data is gathered and the sample size included in the study grows, it will be interesting to note whether the initial trend, as suggested here, continues.


2021 ◽  
Vol 15 (10) ◽  
pp. 1426-1435
Author(s):  
Loay Al Wahaibi ◽  
Rajaa Al Sudairi ◽  
Abdullah Balkhair ◽  
Huda Al-Awaisi ◽  
Mohamed Mabruk

Introduction: Methicillin-Resistant Staphylococcus aureus (MRSA) is a S. aureus strain characterized by resistance to cloxacillin. Healthcare workers (HCWs), are recognized for their heightened risk for MRSA acquisition and possibly for MRSA nosocomial transmission. This cross-sectional study aimed to determine the prevalence and the associated risk factors of MRSA colonization among healthcare workers at Sultan Qaboos University Hospital (SQUH) in Oman. Methodology: A total of 200 nasal swab samples were collected from the healthcare workers at SQUH during the period October 2nd 2018 to January 7th 2019. All nasal swab samples were examined microbiologically for the presence of MRSA using the standard method and the results were confirmed by detection of the mecA product (PBP2a). Data on associated risk factors for MRSA colonization was collected and analyzed. Results: Forty-one of the 200 screened healthcare workers (20.5%) were found to have nasal carriage of Staphylococcus aureus of which 63.4% were Methicillin Sensitive and 36.6% were Methicillin-Resistant (MRSA). Methicillin-Resistant Staphylococcus aureus (MRSA) was isolated from fifteen of the 200 screened healthcare workers giving a prevalence rate of nasal colonization with MRSA of 7.5%. We found no statistical association between healthcare worker MRSA nasal colonization and age, gender, HCWs specialty, hand hygiene practices, skin condition, previous MRSA infection, and previous exposure to antibiotics. Conclusions: Identification of the prevalence and the associated risk factors of MRSA colonization in healthcare workers mandates continuous surveillance and the implementation of all possible preventive measures to reduce re-occurrences.


2013 ◽  
Vol 34 (7) ◽  
pp. 748-750 ◽  
Author(s):  
Victor O. Popoola ◽  
Pranita Tamma ◽  
Nicholas G. Reich ◽  
Trish M. Perl ◽  
Aaron M. Milstone

We studied methicillin-resistant Staphylococcus aureus (MRSA)-colonized children with multiple intensive care unit (ICU) admissions to assess the persistence of MRSA colonization. Our data found that children with more than 1 year between ICU admissions had a higher prevalence of MRSA colonization than the overall ICU population, which supports empirical contact precautions for children with previous MRSA colonization.


2020 ◽  
Author(s):  
Yi-Yu Hsu ◽  
David Wu ◽  
Chien-Ching Hung ◽  
Shie-Shian Huang ◽  
Fang-Hsueh Yuan ◽  
...  

Abstract Objective To evaluate nasal carriage, antibiotic susceptibility and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA), as well as the risk factors of MRSA colonization, in human immunodeficiency virus (HIV)-infected patients in northern Taiwan. Methods From September 2014 to November 2015, HIV-infected patients seeking outpatient care at four hospitals were eligible for this study. A nasal specimen was obtained from each subject for the detection of S. aureus and a questionnaire was completed by each subject. MRSA isolates once identified were characterized. Results Of 553 patients surveyed, methicillin-susceptible S. aureus (MSSA) was detected in 119 subjects (21.5%) and MRSA in 19 subjects (3.4%). Female gender, injection drug use, smoking, hepatitis C virus carrier, cancer and antibiotic use within one year were positively associated with MRSA colonization. By multivariate analysis, only cancer (adjust odds ratio (aOR) 7.78, [95% confidence interval (CI), 1.909-31.731]) and antibiotic use within one year (aOR 3.89, [95% CI, 1.219-12.433]) were significantly associated with MRSA colonization. Ten isolates were characterized as sequence type (ST) 59/staphylococcal chromosome cassette (SCC) IV or V T , endemic community strains in Taiwan, four isolates as ST 8/SCC mec IV (USA 300) and one isolate as ST 239/SCC mec IIIA, a hospital strain. All the community-associated MRSA isolates were susceptible to trimethoprim-sulfamethoxazole (TMP-SMX). Conclusions Nasal MRSA carriage in HIV-infected patients seeking outpatient care was low (3.4%) in northern Taiwan. Most of the colonizing isolates were genetically endemic community strains and exhibited high susceptibility to TMP-SMX and fluoroqinolones. Cancer and antibiotic use within one year were associated with MRSA colonization.


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