Incidence Of Methicillin-resistant Staphylococcus Aureus Colonization Research Articles

Molecular characterization of selected nasal isolates of methicillin-resistant Staphylococcus aureus (MRSA) from healthy students of a tertiary institution

Purpose: To investigate the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and carry out molecular characterization in selected nasal isolates from healthy students in Abraka, Nigeria.Methods: Three hundred (300) samples were obtained from apparently healthy 150 female and 150 male students and were cultured in suitable media for identification. The MRSA were detected by means of oxacillin antibiotic sensitivity disk. Antibiotics susceptibility pattern of MRSA isolates was carried out in accordance with the guidelines of Clinical Laboratory Standard Institute. Tests were carried out to determine the presence of penicillin binding protein2a (PBP2a). Molecular characterization of twenty (20) MRSA representatives was done to establish the existence of the mecA genes among the isolates.Results: The incidence of MRSA colonization amongst apparently healthy students in the community was 68 (22.7 %). The sensitivity pattern was: amoxicillin, 40 (58.8 %); amoxicillin/clavulanate, 15 (22.1 %); chloramphenicol, 15 (22.1 %); ciprofloxacin, 19 (27.9 %); co-trimoxazole, 9 (13.2 %); gentamicin, 9 (13.2 %); ofloxacin, 8 (11.1 %); and streptomycin, 30 (44.1 %). All the twenty (20) isolates subjected to molecular characterization possessed penicillin binding protein2a (PBP2a) while only one possessed the mecA gene.Conclusion: The MRSA is present among healthy individuals in Abraka, Delta State. It is also possible not to detect the existence of the mecA gene even when penicillin binding protein2a is present. Since most of the MRSA isolates are multi-drug resistant, there is a tendency for clinical antibiotic therapy failure in this area.

Factors associated with neonatal surgical site infection after abdominal surgery.

To assess the risk factors for surgical site infections (SSIs) post-abdominal surgery in neonates. A retrospective, single-center cohort study was conducted using patient data from 2009 to 2018. Patient characteristics and several variables were analyzed to identify independent risk factors for SSI. SSI occurred in 39/406 procedures (9.6%). Univariate analysis showed that the incidence of SSI was significantly higher in patients who had undergone multiple surgical procedures (P = 0.032), prolonged operations (P = 0.016), long-term hospitalization (P < 0.001), long-term antibiotic administration (P < 0.001), with methicillin-resistant Staphylococcus aureus (MRSA) colonization (P = 0.044), contaminated/dirty wounds (P < 0.001), and American Society of Anesthesiologists physical status of 3 or 4 (P = 0.021). Multivariate analysis identified prolonged operations [odds ratio (OR): 2.91 (1.21-8.01)] and contaminated/dirty wounds [OR: 5.42 (2.41-12.1)] as independent risk factors. Patients with SSI had a higher incidence of MRSA colonization (27.8% vs. 14.8%, P = 0.044), longer antibiotic administration (24days vs. 8days, P = 0.049), and longer hospitalization times (98days vs. 43days, P = 0.007) than those without SSIs. Long operations exceeding 100min and surgical procedures with contaminated/dirty wounds are independent risk factors for neonatal SSIs after abdominal surgery. SSIs were related to MRSA colonization during hospitalization, long-term antibiotic administration, and long-term hospitalization.

Evaluation of biofilm and enterotoxin producing capacity of methicillin-resistant &lt;i&gt;Staphylococcus aureus&lt;/i&gt; isolated from healthy persons

This study is aimed at investigating biofilm and enterotoxin producing capacity of methicillin-resistant Staphylococcus aureus isolated from nostrils of healthy students of Delta State University Oleh campus. Three hundred (300) nasal samples were collected using sterile swab stick and the isolates were identified using relevant biochemical tests. Determination of methicillin-resistant Staphylococcus aureus was carried out with the aid of Oxacillin sensitivity disc to test the presence of penicillin binding protein2a (PBP2a). The Methicillin-resistant Staphylococcus aureus (MRSA) isolates were screened to determine their biofilm producing ability using crystal binding assay. Latex agglutination test was carried out to detect the presence of enterotoxins among the MRSA isolates. The incidence of MRSA colonization among healthy individuals in the community of the S. aureus isolated was 47 (48.9%). Enterotoxins B was mostly detected, only three Enterotoxin C were detected. All the MRSA isolates tested for the presence of biofilm showed positive results. It has been observed that MRSAs are capable of producing biofilms and enterotoxins which pose the risk antibiotic resistance and human Staphylococci toxicity.Keywords: Enterotoxins, Biofilm, Staphylococcus aureus

Incidence of Methicillin-Resistant Staphylococcus aureus (MRSA) Carrier Status in Patients Undergoing Post-Mastectomy Breast Reconstruction.

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) carriers and infections continues to rise. Some specialties have demonstrated a reduction in infection through appropriate screening and treatment. We sought to investigate the incidence of preoperative colonization, postoperative conversion, and whether this had any impact on outcomes in patients undergoing post-mastectomy breast reconstruction (BR). This is a prospective study of a series of 122 BR patients from a single surgeon from May 2013 to March 2015. Nasal swabs were obtained at preoperative and postoperative clinic visits. The incidence of preoperative and postoperative colonization, demographic, and clinical variables were analyzed and compared to complication rates within 90 days of surgery. The incidence of MRSA colonization was 3.3% (n = 4) preoperatively and 4.1% (n = 5) postoperatively. One patient was positive at both time points, and 4 patients converted postoperatively. Preoperative or postoperative colonization with MRSA was not associated with any specific patient demographics. Hospital length of stay tended to be longer in patients colonized both preoperatively (2.8 days vs 1.6 days, P = .075) and postoperatively (2.8 days vs 1.8 days, P = .072). Postoperative colonization trended toward an increased incidence of any complication (80.0% vs 35.7%, P = .068) and was significantly associated with delayed wound healing (40.0% vs 4.8%, P = .035). Having a minor complication (P = .073) and implant exposure (P = .056) tended to be associated with postoperative carriers. The incidence of MRSA in breast reconstruction patients is relatively low, yet complications rates are higher in those patients. Multicenter randomized trials should be conducted to determine if there is a role for preoperative screening and treatment of MRSA carriers. 2 Risk.

Staphylococcus colonization, mortality and morbidity in hemodialysis patients: 10 years of observation

Colonization with Staphylococci is widely distributed among patients with end-stage renal disease who are receiving hemodialysis (HD). In addition to more intensive care and use of artificial devices, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection has increased. Such colonization has recently been associated with a more than doubled mortality rate in HD patients. However, it is not clear whether the (presumably increasing) incidence of methicillin-sensitive Staphylococcus aureus (MSSA) colonization is associated with MRSA and/or morbidity and mortality. We therefore established a screening program in our HD population (n=156) and followed these patients over 10 years. We discovered eighty-eight MSSA-colonized patients and one MRSA-colonized patient by cross-sectional and admission-related screenings between 2000 and 2010. The morbidity and mortality of the HD patients was not related to MSSA colonization. The MSSA colonization rate decreased slightly during the 10-year observation period. We conclude that the incidence of MRSA colonization in our unit was lower compared to that reported in the literature. The reasons for this finding are complex and require further investigation. The incidence of MSSA colonization was frequent but did not impact morbidity or mortality.

Clinical Incidence of Methicillin-Resistant Staphylococcus aureus (MRSA) Colonization or Infection as a Proxy Measure for MRSA Transmission in Acute Care Hospitals

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonization or infection has been used as a proxy measure for MRSA transmission, but incidence calculations vary depending on whether active surveillance culture (ASC) data are included. To evaluate the relationship between incidences of MRSA colonization or infection calculated with and without ASCs in intensive care units and non-intensive care units. A Veterans Affairs medical center. From microbiology records, incidences of MRSA colonization or infection were calculated with and without ASC data. Correlation coefficients were calculated for the 2 measures, and Poisson regression was used to model temporal trends. A Poisson interaction model was used to test for differences in incidence trends modeled with and without ASCs. The incidence of MRSA colonization or infection calculated with ASCs was 4.9 times higher than that calculated without ASCs. Correlation coefficients for incidences with and without ASCs were 0.42 for intensive care units, 0.59 for non-intensive care units, and 0.48 hospital-wide. Trends over time for the hospital were similar with and without ASCs (incidence rate ratio with ASCs, 0.95 [95% confidence interval, 0.93-0.97]; incidence rate ratio without ASCs, 0.95 [95% confidence interval, 0.92-0.99]; P = .68). Without ASCs, 35% of prevalent cases were falsely classified as incident. At 1 Veterans Affairs medical center, the incidence of MRSA colonization or infection calculated solely on the basis of clinical culture results commonly misclassified incident cases and underestimated incidence, compared with measures that included ASCs; however, temporal changes were similar. These findings suggest that incidence measured without ASCs may not accurately reflect the magnitude of MRSA transmission but may be useful for monitoring transmission trends over time, a crucial element for evaluating the impact of prevention activities.

Effect of a Multifaceted Intervention on Adherence to Hand Hygiene among Healthcare Workers: A Cluster-Randomized Trial

Adherence to hand hygiene among healthcare workers (HCWs) is widely believed to be a key factor in reducing the spread of healthcare-associated infection. The objective of this study was to evaluate the impact of a multifaceted intervention to increase rates of adherence to hand hygiene among HCWs and to assess the effect on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) colonization. Cluster-randomized controlled trial. Thirty hospital units in 3 tertiary care hospitals in Hamilton, Ontario, Canada. After a 3-month baseline period of data collection, 15 units were randomly assigned to the intervention arm (with performance feedback, small-group teaching seminars, and posters) and 15 units to usual practice. Hand hygiene was observed during randomly selected 15-minute periods on each unit, and the incidence of MRSA colonization was measured using weekly surveillance specimens from June 2007 through May 2008. We found that 3,812 (48.2%) of 7,901 opportunities for hand hygiene in the intervention group resulted in adherence, compared with 3,205 (42.6%) of 7,526 opportunities in the control group (P < .001; independent t test). There was no reduction in the incidence of hospital-acquired MRSA colonization in the intervention group. Among HCWs in Ontario tertiary care hospitals, the rate of adherence to hand hygiene had a statistically significant increase of 6% with a multifaceted intervention, but the incidence of MRSA colonization was not reduced.

Successful control of methicillin-resistant Staphylococcus aureus in a spinal cord injury center: a 10-year prospective study including molecular typing

Prospective cohort study with medical record review. To evaluate the clinical utility of an infection control program in a patient cohort at high risk for methicillin-resistant Staphylococcus aureus (MRSA) infection and to identify risk factors interfering with successful decolonization of MRSA. All spinal cord injured (SCI) patients hospitalized at the Swiss Paraplegic Center (SPC) Nottwil from April 1991 to April 2001. Patients whose medical records indicated laboratory-confirmed MRSA colonization or infection were included. Incidence of MRSA colonization or infection was classified as community acquired, nosocomial or transferred based on standardized criteria. Risk factors for community-acquired MRSA colonization in SCI patients were determined. MRSA subtyping and identification of nosocomial spread was performed through pulse-field gel electrophoresis (PFGE). Of 5992 admissions, 100 episodes of MRSA (colonization 22 cases, infection 78 cases) were identified among 76 patients. Overall incidence (1991-2001) per 1000 patient days was 0.26 cases on admission compared to 0.08 at discharge (P<0.001). Community-acquired MRSA was most frequent (56%) followed by nosocomial acquisition (34%). PFGE subtyping identified two nosocomial clusters with six and three cases, respectively. Most of community-acquired MRSA isolates were genetically unrelated and also distinct from epidemic strains identified in Switzerland during the study period. Decolonization was successful in 60 of 76 (78.9%) MRSA-positive patients. In the largest European SCI center, MRSA controlling is feasible if infection control policies are vigorously applied.

Impact of Alcohol-Based, Waterless Hand Antiseptic on the Incidence of Infection and Colonization With Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci

Colonized and infected inpatients are major reservoirs for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), and transient carriage of these pathogens on the hands of healthcare workers remains the most common mechanism of patient-to-patient transmission. We hypothesized that use of alcohol-based, waterless hand antiseptic would lower the incidence of colonization and/or infection with MRSA and VRE. On June 19, 2001, alcohol hand antiseptic was introduced at the University campus and not the nearby Memorial campus of the University of Massachusetts Medical School (Worcester, MA), allowing us to evaluate the impact of this antiseptic on the incidence of MRSA and VRE colonization and infection. From January 1 through December 31, 2001, the incidence of MRSA colonization or infection was compared between the 2 campuses before and after the hand antiseptic was introduced. Its effect on VRE colonization and infection was only studied in the medical intensive care unit at the University campus. At the University campus, the incidence of MRSA colonization or infection decreased from 1.26 cases/1,000 patient-days before the intervention to 0.75 cases/1,000 patient-days after the intervention, for a 1.46-fold decrease (95% confidence interval, 1.04-2.58; P = .037). At the Memorial campus, the incidence of MRSA colonization or infection remained virtually unchanged, from 0.34 cases/1,000 patient-days to 0.49 cases/1,000 patient-days during the same period. However, a separate analysis of the University campus data that controlled for proximity to prevalent cases did not show a significant improvement in the rates of infection or colonization. The incidence of nosocomial VRE colonization or infection before and after the hand antiseptic decreased from 12.0 cases/1,000 patient-days to 3.0 cases/1,000 patient-days, a 2.25-fold decrease (P = .018). Compliance with rectal surveillance for detection of VRE was 86% before and 84% after implementation of the hand antiseptic intervention. The prevalences of VRE cases during these 2 periods were 25% and 29%, respectively (P = .017). Alcohol hand antiseptic appears to be effective in controlling the transmission of VRE. However, after controlling for proximity to prevalent cases (ie, for clustering), it does not appear to be more effective than standard methods for controlling MRSA. Further controlled studies are needed to evaluate its effectiveness.