Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infections outside the healthcare setting are an increasing concern. We conducted a case-control study to investigate an MRSA outbreak during 2002-2003 in a Missouri prison and focused on hygiene factors. Information on sociodemographic characteristics, medical history, and hygiene practices of study participants was collected by interview and medical record review. Logistic regression was used to evaluate MRSA infection in relation to hygiene factors individually and as a composite hygiene score; potential confounding factors were controlled. Selected MRSA isolates were analyzed by pulsed-field gel electrophoresis (PFGE). MRSA infection was significantly associated with a low composite hygiene score. Transmission among prison inmates appeared to be responsible for this outbreak. PFGE analysis showed that isolates were indistinguishable and associated with community-onset MRSA infections in other US prisons. Improving hygiene practices and environmental conditions may help prevent and interrupt future MRSA outbreaks in prison settings.
Highlights
In recent years, outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) infection have been reported in different settings, including among athletic teams and military recruits, as well as in nursing homes and correctional facilities [1,2,3,4,5]
A laboratory investigation of the specimens collected from the infected persons was conducted to identify the strain of S. aureus implicated in the outbreak by pulsed-field gel electrophoresis (PFGE)
The banding pattern of a seventh isolate (SA15) differed by 1 band from the outbreak pattern. In this case-control study of an Methicillin-resistant Staphylococcus aureus (MRSA) outbreak in a prison setting, poor personal hygiene practices were significantly associated with an increased risk for MRSA infection after controlling for sociodemographic and other risk factors
Summary
Outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) infection have been reported in different settings, including among athletic teams and military recruits, as well as in nursing homes and correctional facilities [1,2,3,4,5]. Some outbreak investigations have pointed to personal hygiene as a risk factor for MRSA infection [1,4], few studies identified specific personal hygiene practices associated with increased risk. As part of the investigation and control of this outbreak, a case-control study of risk factors for MRSA infection was conducted, with a focus on personal hygiene factors. A laboratory investigation of the specimens collected from the infected persons was conducted to identify the strain of S. aureus implicated in the outbreak by pulsed-field gel electrophoresis (PFGE).
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