Association of Environmental Contamination in the Home With the Risk for Recurrent Community-Associated, Methicillin-Resistant<i>Staphylococcus aureus</i>Infection

Knox, Justin; Sullivan, Sean B.; Urena, Julia; Miller, Maureen; Vavagiakis, Peter; Shi, Qiuhu; Uhlemann, Anne‐Catrin; Lowy, Franklin D.

doi:10.1001/jamainternmed.2016.1500

Cited by 22 publications

(19 citation statements)

References 58 publications

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“…While the number of invasive MRSA infections has declined slowly over the past decade, our group has identified reservoirs of MSSA (methicillin-susceptible S. aureus ) and MRSA in humans, animals, and the environment [4–11]. Although colonization with S. aureus is usually asymptomatic, it is a risk factor for active infection [12] and enhances the ability of an individual to transmit S. aureus to fomite surfaces [13].…”

Section: Introductionmentioning

confidence: 99%

Characterizing the molecular epidemiology of Staphylococcus aureus across and within fitness facility types

et al. 2019

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BackgroundStaphylococcus aureus is a common bacterium found in the nose and throat of healthy individuals, and presents risk factors for infection and death. We investigated environmental contamination of fitness facilities with S. aureus in order to determine molecular types and antibiotic susceptibility profiles of contaminates that may be transmitted to facility patrons.MethodsEnvironmental swabs (n = 288) were obtained from several fitness facilities (n = 16) across Northeast Ohio including cross-fit type facilities (n = 4), traditional iron gyms (n = 4), community center-based facilities (n = 5), and hospital-associated facilities (n = 3). Samples were taken from 18 different surfaces at each facility and were processed within 24 h using typical bacteriological methods. Positive isolates were subjected to antibiotic susceptibility testing and molecular characterization (PVL and mecA PCR, and spa typing).ResultsThe overall prevalence of S. aureus on environmental surfaces in the fitness facilities was 38.2% (110/288). The most commonly colonized surfaces were the weight ball (62.5%), cable driven curl bar, and CrossFit box (62.5%), as well as the weight plates (56.3%) and treadmill handle (50%). Interestingly, the bathroom levers and door handles were the least contaminated surfaces in both male and female restroom facilities (18.8%). Community gyms (40.0%) had the highest contamination prevalence among sampled surfaces with CrossFit (38.9%), traditional gyms (38.9%), and hospital associated (33.3%) contaminated less frequently, though the differences were not significant (p = 0.875). The top spa types found overall were t008 (12.7%), t267 (10.0%), t160, t282, t338 (all at 5.5%), t012 and t442 (4.5%), and t002 (3.6%). t008 and t002 was found in all fitness facility types accept Crossfit, with t267 (25%), t548, t377, t189 (all 10.7%) the top spa types found within crossfit. All samples were resistant to benzylpenicillin, with community centers having significantly more strains resistant to oxacillin (52.8%), erythromycin (47%), clindamycin (36%), and ciprofloxacin (19%). Overall, 36.3% of isolates were multidrug resistant.ConclusionsOur pilot study indicates that all facility types were contaminated by S. aureus and MRSA, and that additional studies are needed to characterize the microbiome structure of surfaces at different fitness facility types and the patrons at these facilities.

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Section: Introductionmentioning

confidence: 99%

Characterizing the molecular epidemiology of Staphylococcus aureus across and within fitness facility types

et al. 2019

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“…Additionally, the environment plays an important role in S . aureus transmissions and infections not only in healthcare settings [6] but also in some high-risk community settings, including households [7, 8], prisons [9, 10], and public transportation [11, 12]. In an Iranian intensive care unit, S .…”

Section: Introductionmentioning

confidence: 99%

School environmental contamination of methicillin-sensitive Staphylococcus aureus as an independent risk factor for nasal colonization in schoolchildren: An observational, cross-sectional study

et al. 2018

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ObjectiveWe aim to assess the similarities of proportional, phenotypic, and molecular characteristics between the school environment and schoolchildren on methicillin-sensitive S. aureus (MSSA) isolates.MethodsA cross-sectional study was conducted between March 2016 and August 2016 in eight elementary schools in Guangzhou, China. Nasal swabs from students and environmental swabs from school environments were collected. Univariate and multivariate logistic regression analyses under a multistage stratified cluster cross-sectional survey design were performed to access the prevalence relationship and influencing factors, respectively. Phenotypic and molecular characterizations of MSSA isolates were conducted using the Kirby-Bauer disk diffusion method and polymerase chain reaction assays, respectively.ResultsIn total, 1705 schoolchildren and 1240 environmental samples from 40 classes in eight elementary schools obtained between March and August 2016 were include in this study. The rates of MSSA prevalence among schoolchildren and the environment were 11.44% (195/1705) and 4.60% (57/1240), respectively. The odds ratios and 95% confidence intervals (CIs) on the prevalence of MSSA isolates were 1.11 (95% CI, 1.05–1.29; P = 0.010) and 1.04 (95% CI, 1.01–1.07; P = 0.003) for the school or class environment and students, respectively. Similar phenotypic and molecular characteristics were identified between schoolchildren and the environment. A cause and effect relationship could not be established because the study design was cross-sectional.ConclusionsBecause of the cross-sectional design, we can reveal the association between school environment and schoolchildren on MSSA, but it is not a cause and effect relationship.

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“…Likewise, nurses in community settings can also help prevent infections through infection control practices, such as performing hand hygiene and using sterile equipment, and educating patients and informal caregivers on these practices (Higginson, 2017). Finally, environmental factors have been highlighted in previous research as contributing to patient infection risk, including the role of environmental contamination (Knox et al, 2016). The environment in which HHC is delivered is both dynamic and unpredictable and can present barriers to infection prevention and control such as clutter, uncleanliness, and infestations which can hinder nurses in caring for patients by increasing their stress and difficulty in completing tasks without feeling rushed or distracted (Markkanen et al, 2017;Sitzman & Leiss, 2009).…”

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Individual, social, and environmental factors for infection risk among home healthcare patients: A multi‐method study

Russell

Dowding

Trifilio

et al. 2021

Health Soc Care Community

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The ageing of the population, coupled with an increasing prevalence of chronic conditions among older adults and healthcare shifting towards home-based care delivery, have all contributed to rapid growth of home healthcare (HHC) services in the U.S. (Landers et al., 2016;Sisko et al., 2019). Roughly 3.4 million U.S. Medicare beneficiaries received HHC in 2018 (MedPAC, 2020). Quality oversight groups, including the U.S. Centres for Medicare and Medicaid Services, have focused on infections and required HHC agencies to maintain and document an infection control program as a condition of their participation (CMS, 2018). Reported rates of infections that developed in patients while receiving HHC have ranged from 5.1% to 11.5% (Shang et al., 2014). Infections are a leading cause of hospitalisation among HHC patients and have been attributed to as much as 17% of unplanned hospitalisations (Shang et al., 2015).

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Association of Environmental Contamination in the Home With the Risk for Recurrent Community-Associated, Methicillin-ResistantStaphylococcus aureusInfection

Cited by 22 publications

References 58 publications

Characterizing the molecular epidemiology of Staphylococcus aureus across and within fitness facility types

Characterizing the molecular epidemiology of Staphylococcus aureus across and within fitness facility types

School environmental contamination of methicillin-sensitive Staphylococcus aureus as an independent risk factor for nasal colonization in schoolchildren: An observational, cross-sectional study

Individual, social, and environmental factors for infection risk among home healthcare patients: A multi‐method study

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