Control of Methicillin-resistant Staphylococcus aureus in a Burn Unit

Arnow, Paul M.; Allyn, Patricia A.; Nichols, E. Mark; Hill, Dianne; Pezzlo, Marie; Bartlett, Robert H.

doi:10.1097/00005373-198211000-00012

Cited by 101 publications

(65 citation statements)

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“…We can find no other reports of SA5385 outbreaks, but this may reflect the relative rarity of routine S. aureus phage typing. Whilst some (epidemic) MRSA clearly have a propensity to spread, there are likewise many examples of MSSA with similar survival advantages [7][8][9][10][11]. Interestingly, during the SA5385 outbreak, seven sporadic MRSA isolates (including EMRSA 15\16) were identified on the neonatal unit.…”

Section: Discussionmentioning

confidence: 99%

“…We were unable to confirm staff shortages as a significant factor in this outbreak. Staphylococcal outbreaks have been linked to staff shortages and indeed successfully controlled by remedying this issue [8][9][10]. Overcrowding on neonatal units has also been associated with crossinfection [9].…”

Section: Discussionmentioning

confidence: 99%

“…Hand-borne spread is the predominant means of staphylococcal transmission in neonatal units [6,7]. In many outbreaks of methicillin-resistant and methicillin-susceptible S. aureus (MRSA, MSSA), employment of extra staff has brought about a reduction in rates of infection [8][9][10]. In particular, the employment of an infection control nurse often improves the situation by drawing attention to and implementing infection control measures [10].…”

Section: Neonatal Units Provide Ideal Environments Formentioning

confidence: 99%

“…Tested compounds, obtained as pharmaceutical grade powders\solutions or from Sigma (breakpoint concentrations, mg\l), were acriflavine (32), amikacin (8), benzalkonium chloride (8), chloramphenicol (32), chlorhexidine (4), erythromycin (8), ethidium bromide (32), flucloxocallin (4), gentamicin (4), netilmicin (4), penicillin (0nn25), triclosan (4), and trimethoprim (8) [24][25][26]. The control was S. aureus NCTC 6571.…”

Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

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A five year outbreak of methicillin-susceptible Staphylococcus aureus phage type 53,85 in a regional neonatal unit

et al. 2000

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Article ReuseUnless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. SUMMARYWe identified a 5-year outbreak of a methicillin-susceptible Staphylococcus aureus (MSSA) strain, affecting 202 babies on a neonatal unit, by routine weekly phage typing all S. aureus isolates. Multiple staged control measures including strict emphasis on hand hygiene, environmental and staff surveillance sampling, and application of topical hexachlorophane powder failed to end the outbreak. S. aureus PT 53,85 (SA5385) was found on opened packs of Stomahesive2, used as a neonatal skin protectant. Only following the implementation of aseptic handling of Stomahesive, and the use of topical mupirocin for staff nasal carriers of SA5385, and for babies colonized or infected with S. aureus, did the isolation rate of SA5385 decline. DNA fingerprinting indicated that 95 % of SA5385 isolates were clonal. In itro death rates of SA5385 on Stomahesive with human serum were significantly lower than on Stomahesive alone (P l 0n04), and on cotton sheet with serum (P l 0n04), highlighting the potential of this material as a survival niche. Phage typing remains a valuable, inexpensive and simple method for monitoring nosocomial MSSA infection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Neonatal Units Provide Ideal Environments Formentioning

confidence: 99%

Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

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A five year outbreak of methicillin-susceptible Staphylococcus aureus phage type 53,85 in a regional neonatal unit

et al. 2000

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“…In a study conducted in a large neonatal intensive care unit (NICU) in the mid-1970s, the role of overcrowding and understaffing, and their association with recurrent exacerbations of staphylococcal infections, was observed (21). Experiences in other NICUs and other units have confirmed these initial observations (22)(23)(24). In an elegant study, Haley et al (25) demonstrated an association between persistent Adult ID Notes understaffing and overcrowding in an NICU and high methicillin-resistant Staphylococcus aureus (MRSA) infection rates by using a measure of intensity-of-care requirements and changes in severity-of-illness case mix.…”

mentioning

confidence: 91%

The Impact of Health Care Restructuring on Nosocomial Infections and Transmission of Antimicrobial Resistant Organisms

Conly

Johnston

2001

Canadian Journal of Infectious Diseases and Medical Microbiolog

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T he past decade has seen a dramatic change in Canadian health care as the treatment of many patients shifts from the hospital setting to the home or other alternative health care settings (1). Complex advances in technology and significant changes in the funding environment have also precipitated many changes in the functional capacity of our health care system. The portion of the total Canadian health care expenditures that has been allocated to hospitals and other institutions has declined steadily over the past two decades (2,3). This reduction in institutional-based funding reflects the need to develop a system that improves the use of out-ofhospital sites for delivery of health care services and decreases reliance on the specific institutional component of the health care sector. Recent data reveal that Canadian hospital discharge rates have decreased by 14% between 1994 and 1998, and there has been a reduction in the length of stay from 7.4 to 7 days (4). In conjunction with a reduction in the number of hospital beds, there has been a massive shift in the proportion of surgeries that are performed on an outpatient basis. Further developments in the delivery of care include the increased use of telehealth, which allows health care professionals to provide increasingly complex services centralized hospital sites to outlying areas.The shifts in the funding and delivery of health care services have produced an array of new and difficult challenges. First, the shift in patient care has caused an increase in the severity and acuity of illness among patients receiving care in the hospital environment compared with hospitalized patients in previous decades. These shifts have led to critical care beds. Thus, patients who now receive care in the hospital setting may be at an increased risk for a number of adverse outcomes including nosocomial infections, deep vein thrombosis, pulmonary embolism, upper gastrointestinal bleeding, central nervous system complications, decubitis ulcers, sepsis and increased transmission of antimicrobialresistant organisms. The present article briefly reviews important aspects of the restructured hospital environment and how they may contribute to an increased risk for nosocomial infections and the transmission of antimicrobialresistant microbes. In addition, relevant data that support this hypothesis are reviewed. Several factors unique to the current restructured health care setting may contribute to an increased propensity for nosocomial infections and the transmission of antimicrobialresistant pathogens. These factors may be related to the host, the host-microbe interaction, the use of antimicrobials, the host-antimicrobial interaction, the host environment (including the physical plant, general environmental hygiene, the

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Risk factors for nosocomial infection in intensive care. 'Devices vs nature' and goals for the next decade

Dg¹

1989

Archives of Internal Medicine

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Control of Methicillin-resistant Staphylococcus aureus in a Burn Unit

Cited by 101 publications

References 0 publications

A five year outbreak of methicillin-susceptible Staphylococcus aureus phage type 53,85 in a regional neonatal unit

A five year outbreak of methicillin-susceptible Staphylococcus aureus phage type 53,85 in a regional neonatal unit

The Impact of Health Care Restructuring on Nosocomial Infections and Transmission of Antimicrobial Resistant Organisms

Risk factors for nosocomial infection in intensive care. 'Devices vs nature' and goals for the next decade

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