Epidemiology and Treatment of Chronic Staphylococcal Infections in the Household

Nahmias, A.J.; Lepper, Mark H.; Hurst, Valerie; Mudd, Stuart

doi:10.2105/ajph.52.11.1828

Cited by 23 publications

(7 citation statements)

References 43 publications

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“…The origin and transmission pathways of community-acquired MRSA are for the most part unknown. It has previously been recognized that Staphylococcus aureus can be shared among household contacts [3,4], but the prevalence and importance of transmission of MRSA among family members are largely unknown. Transmission of MRSA is known to have occurred from medical staff to their family members [5 Á7] and case reports of intrafamilial spread have been described [8Á11].…”

Section: Introductionmentioning

confidence: 99%

High prevalence of MRSA in household contacts

Johansson

Gustafsson

Ringberg

2007

Scandinavian Journal of Infectious Diseases

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In a 6-y period, 114 household contacts connected to newly diagnosed MRSA patients screened for MRSA in the southern part of Sweden. In 22 of 51 (43%) families, 1 to 4 household contact(s) connected to a MRSA patient were positive for MRSA. In the 22 families, 42 of 60 (70%) household contacts were positive for MRSA and transmission of MRSA occurred between adult couples, parents and children, grandparent and children and between siblings. Within a family, MRSA-positive family members had in all but 1 instance identical MRSA strain genotypes (spa types) making intrafamilial spread of MRSA highly probable. MRSA transmission among household contacts may contribute to the prevalence of MRSA in the community and failure to identify MRSA in household contacts may maintain MRSA colonization in an already known MRSA patient. MRSA screening of family members living in the same household as a known MRSA patient should therefore be considered.

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Section: Introductionmentioning

confidence: 99%

High prevalence of MRSA in household contacts

Johansson

Gustafsson

Ringberg

2007

Scandinavian Journal of Infectious Diseases

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“…In the past, it has been shown that carriers of Staphylococcus aureus and MRSA can be a source of transmission of these pathogens to their household contacts (5,17,18,21,26). The exact risk factors for transmission of MRSA to household contacts have not been studied properly, but close contact, the environment, or being an HCW are thought to be plausible risk factors for transmission (28,29,32).…”

mentioning

confidence: 99%

Transmission of Methicillin-Resistant Staphylococcus aureus to Household Contacts

et al. 2010

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The frequency of and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) transmission from a MRSA index person to household contacts were assessed in this prospective study. Between January 2005 and December 2007, 62 newly diagnosed MRSA index persons (46 patients and 16 health care workers) and their 160 household contacts were included in the study analysis. Transmission of MRSA from an index person to household contacts occurred in nearly half of the cases (47%; n ‫؍‬ 29). These 29 index persons together had 84 household contacts, of which two-thirds (67%; n ‫؍‬ 56) became MRSA positive. Prolonged exposure time to MRSA at home was a significant risk factor for MRSA transmission to household contacts. In addition, MRSA colonization at least in the throat, younger age, and eczema in index persons were significantly associated with MRSA transmission; the presence of wounds was negatively associated with MRSA transmission. Furthermore, an increased number of household contacts and being the partner of a MRSA index person were householdrelated risk factors for MRSA acquisition from the index person. No predominant pulsed-field gel electrophoresis (PFGE) type was observed to be transmitted more frequently than other PFGE types. To date, screening household contacts and providing MRSA eradication therapy to those found positive simultaneously with the index person is not included in the "search-and-destroy" policy. We suggest including both in MRSA prevention guidelines, as this may reduce further spread of MRSA.

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“…This is not surprising because we have known for decades that S. aureus is transmitted to family and other close contacts in the community setting [43]. The more MRSA that is sent home from health care facilities, the more spread should be expected within the community.…”

Section: Epidemiology Of Methicillin-resistant Staphylococcus Aureus mentioning

confidence: 98%

Methicillin-resistant Staphylococcus aureus infections

Farr

1999

Curr Infect Dis Rep

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Methicillin-resistant Staphylococcus aureus (MRSA) has continued to spread and cause serious nosocomial infections. Failure to control MRSA may result in higher rates of use of glycopeptides, which may, in turn, lead to higher rates of glycopeptide resistance. Resistance to glycopeptides has recently begun to appear in S. aureus. Transfer of glycopeptide-resistance genes from enterococci to S. aureus has been documented in laboratory experiments but has not yet been found in clinical isolates. Over time, MRSA is becoming more common in various subsets of the general population. Some studies claim that many MRSA-colonized outpatients and their close contacts have had no health care contacts, but these studies have usually not considered contacts in outpatient clinics. Several other recent studies have found that all or a vast majority of patients with MRSA have had frequent contact with health care providers. Failure to wash hands and disinfect equipment between patients, which has been commonly seen in studies of health care worker compliance with infection control measures, may explain much of the continuing spread. The source of spread of antibiotic-resistant microbes can be likened to an iceberg, with clinically obvious infections representing the tip of the iceberg and most of the spread coming from clinically inapparent colonized patients who represent most of the reservoir for transmission. Surveillance cultures to identify this reservoir are important to the control of spread with effective barrier precautions. Such precautions have been shown to reduce the spread of MRSA 15.6-fold compared with standard precautions.

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Epidemiology and Treatment of Chronic Staphylococcal Infections in the Household

Abstract: The epidemiological cycles of chronic staphylococcal infections in households are discussed and the various methods of control that have been used are examined. The authors conclude there is no sovereign remedy and suggest a number of possibilities for research.

Cited by 23 publications

References 43 publications

High prevalence of MRSA in household contacts

High prevalence of MRSA in household contacts

Transmission of Methicillin-Resistant Staphylococcus aureus to Household Contacts

Methicillin-resistant Staphylococcus aureus infections

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