MRSA and the environment: implications for comprehensive control measures

Cimolai, Nevio

doi:10.1007/s10096-008-0471-0

Cited by 79 publications

(56 citation statements)

References 166 publications

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“…For example, doors proved to be, as is the case in human hospitals, an important hot spot for MRSA contamination (6 isolates of 19). Several studies have also reported the presence of MRSA on doors in human (Oie et al 2002, Cimolai 2008) and veterinary hospitals (Loeffler et al 2005, Heller et al 2009), indicating that they may be one of the most important sources for dissemination of this pathogen in a hospital setting even during a nonoutbreak period.…”

Section: Discussionmentioning

confidence: 99%

Environmental Methicillin-ResistantStaphylococcus aureusin a Veterinary Teaching Hospital During a Nonoutbreak Period

Hoet

Johnson

Nava-Hoet

et al. 2011

Vector-Borne and Zoonotic Diseases

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Concurrent to reports of zoonotic and nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in veterinary settings, recent evidence indicates that the environment in veterinary hospitals may be a potential source of MRSA. The present report is a cross-sectional study to determine the prevalence of MRSA on specific human and animal contact surfaces at a large veterinary hospital during a nonoutbreak period. A total of 156 samples were collected using Swiffers Ò or premoistened swabs from the small animal, equine, and food animal sections. MRSA was isolated and identified by pre-enrichment culture and standard microbiology procedures, including growth on Mueller-Hinton agar supplemented with NaCl and oxacillin, and by detection of the mecA gene. Staphylococcal chromosome cassette mec (SCCmec) typing and pulsed-field gel electrophoresis profile were also determined. MRSA was detected in 12% (19/157) of the hospital environments sampled. The prevalence of MRSA in the small animal, equine, and food animal areas were 16%, 4%, and 0%, respectively. Sixteen of the MRSA isolates from the small animal section were classified as USA100, SCCmec type II, two of which had pulsed-field gel electrophoresis pattern that does not conform to any known type. The one isolate obtained from the equine section was classified as USA500, SCCmec type IV. The molecular epidemiological analysis revealed a very diverse population of MRSA isolates circulating in the hospital; however, in some instances, multiple locations/surfaces, not directly associated, had the same MRSA clone. No significant difference was observed between animal and human contact surfaces in regard to prevalence and type of isolates. Surfaces touched by multiple people (doors) and patients (carts) were frequently contaminated with MRSA. The results from this study indicate that MRSA is present in the environment even during nonoutbreak periods. This study also identified specific surfaces in a veterinary environment that need to be targeted when designing and executing infection control programs.

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Section: Discussionmentioning

confidence: 99%

Environmental Methicillin-ResistantStaphylococcus aureusin a Veterinary Teaching Hospital During a Nonoutbreak Period

Hoet

Johnson

Nava-Hoet

et al. 2011

Vector-Borne and Zoonotic Diseases

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“…The extent to which such susceptible patients' environments act as a reservoir for infections is contradictory with some authors [3,8,10,16] suggesting that transmission of HCAIs by this route is plausible. Some studies described that the contribution of the environment is negligible [7,9,12,14,18].…”

Section: Introductionmentioning

confidence: 90%

An Exploratory Study of Staphylococcus epidermidis Isolates from Environment and Patient Blood Cultures from an Intensive Care Unit

Damaceno¹,

Oliveira²,

Randle³

2014

Infections Journal

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This exploratory study determined the epidemiological characteristics of Staphylococcus epidermidis from near touch sites and blood cultures in one Intensive Care Unit (ICU) between July and October 2009 in a large teaching hospital in Brazil. Five different touch sites around the environment of two different patients were sampled over four days and 24 blood cultures from 24 patients were obtained and analyzed. Isolates from near touch sites and blood cultures were compared by means of the repetitive extragenic palindromic sequence-based polymerase chain reaction (rep-PCR) and analyzed by the unweighted pair-group method with arithmetic mean (UPGMA) (BioNumerics, 6.0). Results found that ciprofloxacinresistant Staphylococcus epidermidis on stethoscopes, bed rails (P < .004), and patient blood cultures indicated similarity (60-65%; IC: 85%). The similarities among near touch sites and patient isolates are unsurprising due to the commensal nature of Staphylococcus epidermidis, however it does emphasize the need for further research into environmental contamination and cleaning.

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“…Experience in countries with a high prevalence of MRSA, such as the UK, shows that hospital environments are often contaminated with MRSA. The major MRSA reservoirs in hospitals are the noses and hands of patients as well as staff and visitors, equipment, clothing, bedding, curtains and floors (Cimolai, N., 2008). An unpublished study 4 found 0/89 professional meat handlers colonized with MRSA, although the sample size examined here was inadequate to generate firm conclusions.…”

Section: 7mentioning

confidence: 99%

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2009

EFSA Journal

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SUMMARYThe European Food Safety Authority (EFSA) asked its Panel on Biological Hazards to deliver a scientific opinion on: The assessment of the Public Health significance of meticillin resistant Staphylococcus aureus (MRSA).There are different states of interaction between S. aureus and its host: infections, carriage or colonisation, and contamination. Meticillin resistant S. aureus (MRSA) can be persistently or intermittently carried by healthy humans, and colonisation is the major risk factor for infection. Infection can be mild to severe and, in some instances, fatal. MRSA are now a major cause of hospital acquired infection in many European countries, with large differences in prevalence and control policies. A limited number of lineages of MRSA tend to predominate in specific geographical locations. CC398 is the MRSA lineage most often associated with asymptomatic carriage in intensively reared food-producing animals. MRSA commonly carry enterotoxin genes but there has been only one report of food intoxication due to MRSA. On the question on what is the risk to human health posed by MRSA associated with foodproducing animals, the Panel concluded that:Livestock-associated MRSA (LA-MRSA) represent only a small proportion of the total number of reports of MRSA infections in the EU. However, this proportion differs between Member States. In some countries with low prevalence of human MRSA infection, CC398 is a major contributor to the overall MRSA burden. In countries with high overall human MRSA prevalence, CC398 is considered of less significance for the public health. CC398 has, albeit rarely, been associated with deep-seated infections of skin and soft tissue, pneumonia and septicaemia in humans. Where CC398 prevalence is high in food-producing animals, people in contact with these live animals (especially farmers and veterinarians, and their families) are at greater risk of colonisation and infection than the general population. The risk to human health from different levels (dose response) of MRSA during carriage in animals (and in the environment) is not known. On the question of what is the importance of food, food-producing animals, and companion animals in the risk of human infection and/or food-borne disease caused by MRSA in both the community and hospital settings, the Panel concluded that:Food may be contaminated by MRSA (including CC398): eating and handling contaminated food is a potential vehicle for transmission. There is currently no evidence for increased risk of human colonisation or infection following contact or consumption of food contaminated by CC398 both in the community and in hospital. MRSA (including CC398) can enter the slaughterhouse in or on animals and occurs on raw meat. Although it may become part of the endemic flora of the slaughterhouse, the risk of infection to slaughterhouse workers and persons handling meat appears to be low based on currently available data.Where CC398 prevalence is high in food-producing animals, people in direct contact with these live animals (espe...

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MRSA and the environment: implications for comprehensive control measures

Cited by 79 publications

References 166 publications

Environmental Methicillin-ResistantStaphylococcus aureusin a Veterinary Teaching Hospital During a Nonoutbreak Period

Environmental Methicillin-ResistantStaphylococcus aureusin a Veterinary Teaching Hospital During a Nonoutbreak Period

An Exploratory Study of Staphylococcus epidermidis Isolates from Environment and Patient Blood Cultures from an Intensive Care Unit

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