scholarly journals The Prevalence, Risk, and Management of Methicillin-Resistant Staphylococcus aureus Infection in Diverse Populations across Canada: A Systematic Review

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 393 ◽  
Author(s):  
Elena Mitevska ◽  
Britney Wong ◽  
Bas G. J. Surewaard ◽  
Craig N. Jenne

Methicillin-resistant Staphylococcus aureus (MRSA) first emerged after methicillin was introduced to combat penicillin resistance, and its prevalence in Canada has increased since the first MRSA outbreak in the early 1980s. We reviewed the existing literature on MRSA prevalence in Canada over time and in diverse populations across the country. MRSA prevalence increased steadily in the 1990s and 2000s and remains a public health concern in Canada, especially among vulnerable populations, such as rural, remote, and Indigenous communities. Antibiotic resistance patterns and risk factors for MRSA infection were also reported. All studies reported high susceptibility (>85%) to trimethoprim-sulfamethoxazole, with no significant resistance reported for vancomycin, linezolid, or rifampin. While MRSA continues to have susceptibility to several antibiotics, the high and sometimes variable resistance rates to other drugs underscores the importance of antimicrobial stewardship. Risk factors for high MRSA infection rates related to infection control measures, low socioeconomic status, and personal demographic characteristics were also reported. Additional surveillance, infection control measures, enhanced anti-microbial stewardship, and community education programs are necessary to decrease MRSA prevalence and minimize the public health risk posed by this pathogen.

2017 ◽  
Vol 18 (5) ◽  
pp. 224-230 ◽  
Author(s):  
Mark I. Garvey ◽  
Craig W. Bradley ◽  
Kerry L. Holden ◽  
Beryl Oppenheim

Aims: We describe the investigation and control of a nosocomial outbreak of Sequence Type (ST) 22 MRSA containing the Panton–Valentine leucocidin (PVL) toxin in an acute multispecialty surgical ward at University Hospital Birmingham NHS Foundation Trust. Methods: A patient was classed as acquiring methicillin-resistant Staphylococcus aureus (MRSA) if they had a negative admission screen and then had MRSA isolated from a subsequent screen or clinical specimen. Spa typing and pulsed field gel electrophoresis (PFGE) was undertaken to confirm MRSA acquisitions. Findings: The Infection Prevention and Control Team were alerted to the possibility of an outbreak when two patients acquired MRSA while being on the same ward. In total, five patients were involved in the outbreak where four patients acquired the PVL-MRSA clone from an index patient due to inadequate infection control practice. Two patients who acquired the strain developed a bloodstream infection. Infection control measures included decolonisation of affected patients, screening of all patients on the ward, environmental sampling and enhanced cleaning. Discussion: Our study highlights the potential risk of spread and pathogenicity of this clone in the healthcare setting. Spa typing and PFGE assisted with confirmation of the outbreak and implementation of infection control measures. In outbreaks, microbiological typing should be undertaken as a matter of course as without specialist typing identification of the described outbreak would have been delayed.


2016 ◽  
Vol 78 (5) ◽  
Author(s):  
A. M. Setiawan

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most complicated problems in infection control and disease prevention. Imported strains or group of similar strains called clones were introduced from other states within Australia and also from other countries. Western Australia (WA) MRSA clones known to be the most predominant clones circulating in Western Australia (WA). However, MRSA strains originally from other states and countries outside Australia (imported) have increased in number in the last decades. The aim of this study was to examine the epidemiology of CA MRSA clones in Western Australia for the past 11 year’s period (2003-2013). There were 10 predominant clones of CA-MRSA circulating in WA with WA MRSA-1 (32,82%), Queensland (22,67 %) and WA MRSA-2 (22,67 %) clones as the top three predominant clones. The percentage of PVL positive CA-MRSA clones such as Queensland (Qld) clone has been increasing significantly (R2=0,67) from 2,38 % in 2002 to 25,69% in 2013. In contrast, the percentages of two major PVL negative clones, WA MRSA-1 and WA MRSA 2, have been decreasing nearly by half from 52,38 % to 27,71 % and 30,95 % to 16,59 % respectively in the last 11 years. PVL positive clones have been introduced in WA from other states and overseas in the last eleven years. Due to the virulence factor of PVL toxin, the emergence of PVL positive CA-MRSA should be considered as public health concerns.


2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S373-S374
Author(s):  
Ian Kracalik ◽  
Kelly Jackson ◽  
Joelle Nadle ◽  
Wendy Bamberg ◽  
Susan Petit ◽  
...  

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) causes >70,000 invasive infections annually in the United States, and recurrent infections pose a major clinical challenge. We examined risk factors for recurrent MRSA infections. Methods We identified patients with an initial invasive MRSA infection (isolation from a normally sterile body site) from 2006 to 2013, through active, population-based surveillance in selected counties in nine states through the Emerging Infections Program. Recurrence was defined as invasive MRSA isolation >30 days after initial isolation. We used logistic regression with backwards selection to evaluate adjusted odds ratios (aOR) associated with recurrence within 180 days, prior healthcare exposures, and initial infection type, controlling for patient demographics and comorbidities. Results Among 24,478 patients with invasive MRSA, 3,976 (16%) experienced a recurrence, including 61% (2,438) within 180 days. Risk factors for recurrence were: injection drug use (IDU) (aOR; 1.38, 95% confidence interval [CI]: 1.15–1.65), central venous catheters (aOR; 1.35, 95% CI: 1.22–1.51), dialysis (aOR; 2.00, 95% CI: 1.74–2.31), and history of MRSA colonization (aOR; 1.35, 95% CI: 1.22–1.51) (figure). Recurrence was more likely for bloodstream infections (BSI) without another infection (aOR; 2.08, 95% CI: 1.74–2.48), endocarditis (aOR; 1.46, 95% CI: 1.16–1.55), and bone/joint infections (aOR; 1.38, 95% CI: 1.20–1.59), and less likely for pneumonia (aOR: 0.75, 95% CI: 0.64–0.89), compared with other initial infection types. When assessed separately, the presence of a secondary BSI with another infection increased the odds of recurrence over that infection without a BSI (aOR: 1.96, 95% CI: 1.68–2.30). Conclusion Approximately one in six persons with invasive MRSA infection had recurrence. We identified potential opportunities to prevent recurrence through infection control (e.g., management and early removal of central catheters). Other possible areas for preventing recurrence include improving the management of patients with BSI and bone/joint infections (including both during and after antibiotic treatment) and mitigating risk of infection from IDU. Disclosures All authors: No reported disclosures.


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