Examination of Staphylococcus aureus Isolates from the Gloves and Gowns of Intensive Care Unit Health Care Workers

Adedrian, Timileyin; Hitchcock, Stephanie; O’Hara, Lyndsay M.; Michalski, Jane; Johnson, J. Kristie; Calfee, David P.; Miller, Loren G.; Hazen, Tracy H.; Harris, Anthony D.; Rasko, David A.

doi:10.1128/mra.00691-20

Cited by 1 publication

(3 citation statements)

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“…Our cohort contained clinical or surveillance MRSA isolates from 388 independent patients from the intensive care unit (ICU) and the paired isolates from the corresponding HCP's gown or gloves, as part of a previously described study. 5,12,13 In the parent study by O'Hara et al, 5 the MRSA isolates from each patient were defined as high, mid-level, or low transmitters, with the low transmitters having no transmission events that occurred from the patient to HCP. The low-transmitting isolates were not included in this analysis.…”

Section: Isolate Selectionmentioning

confidence: 99%

“…Swabs were cultured onto a CHROMagar MRSA (Becton Dickinson, Sparks, MD) and incubated overnight. 5,12,13 From the 388 independent patient isolates, we selected 96 paired isolates using stratified sampling. We selected the patient isolates in proportion to the number of the isolates that were identified as part of the different genomic clades identified in our previous study.…”

Section: Isolate Selectionmentioning

confidence: 99%

“…The genome sequencing and assembly used to analyze the patient isolates and HCP glove and gown isolates was described in Adediran et al 12,13 After 5 pair of isolates were removed from the analysis due to failing quality control metrics after sequencing or molecular typing issues, 91 pairs of isolates remained. Thus, 182 total isolates were included in the genomic epidemiology studies.…”

Section: Genome Sequencingmentioning

confidence: 99%

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Molecular concordance of methicillin-resistant Staphylococcus aureus isolates from healthcare workers and patients

Adediran

Hitchcock²,

Johnson³

et al. 2022

Infect. Control Hosp. Epidemiol.

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Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant nosocomial pathogen in the ICU. MRSA contamination of healthcare personnel (HCP) gloves and gowns after providing care to patients with MRSA occurs at a rate of 14%–16% in the ICU setting. Little is known about whether the MRSA isolates identified on HCP gown and gloves following patient care activities are the same as MRSA isolates identified as colonizing or infecting the patient. Methods: From a multisite cohort of 388 independent patient MRSA isolates and their corresponding HCP gown and glove isolates, we selected 91 isolates pairs using a probability to proportion size (PPS) sampling method. To determine whether the patient and HCP gown or gloves isolates were genetically similar, we used 5 comparative genomic typing methods: phylogenetic analysis, spa typing, multilocus sequence typing (MLST), large-scale BLAST score ratio (LSBSR), and single-nucleotide variant (SNV) analysis. Results: We identified that 56 (61.5%) of isolate pairs were genetically similar at least by 4 of the methods. Comparably, the spa typing and the LSBSR analyses revealed that >75% of the examined isolate pairs were concordant, with the thresholds established for each analysis. Conclusions: Many of the patient MRSA isolates were genetically similar to those on the HCP gown or gloves following a patient care activity. This finding indicates that the patient is often the primary source of the MRSA isolates transmitted to the HCP, which can potentially be spread to other patients or hospital settings through HCP vectors. These results have important implications because they provide additional evidence for hospitals considering ending the use of contact precautions (gloves and gowns) for MRSA patients.

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