MRSA outbreak in a tertiary neonatal intensive care unit in Iceland

Kristinsdóttir, Íris Mýrdal; Haraldsson, Ásgeir; Þórkelsson, Þórður; Haraldsson, Gunnsteinn; Kristinsson, Karl G.; Larsen, Jesper; Larsen, Anders Rhod; Thors, Valtýr

doi:10.1080/23744235.2019.1662083

Cited by 9 publications

(12 citation statements)

References 35 publications

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“…To reduce spread, targeted MRSA screening in high-risk departments such as NICUs as proposed by Kristinsdottir et. al could be considered [ 3 ]. As approximately 10% of all neonates in Denmark are admitted to NICU, routine MRSA screening of either mother or infant upon NICU admission and not just when transferred between NICUs would amount to an additionally 6000 admissions screenings each year.…”

Section: Discussionmentioning

confidence: 99%

“…al. [ 3 ] and Bozzella et al [ 23 ] emphasize the possibility of earlier recognition of possible outbreaks if systematic screenings being introduced, e.g. weekly testing, especially in long term NICU stays.…”

Section: Discussionmentioning

confidence: 99%

“…The MRSA prevalence within different age groups in our catchment area is highest among children between 0–4 years, and adults between 25–39 years of age (unpublished data), the latter being the typical age of pregnant women and their partners. The increasing number of mainly CA-MRSA in this age group is worrying, as it is hypothesized that the MRSA outbreak strain usually enters the NICU with a colonized parent [ 3 ]. A total of 27 MRSA outbreaks have been registered at the 17 Danish NICUs in the period 2008 to 2019.…”

Section: Introductionmentioning

confidence: 99%

“…It has been suggested that MRSA admission screening, especially in high risk settings such as intensive care units, could be useful for early recognition of asymptomatic MRSA carriage and outbreak prevention [ 3 , 15 , 16 ]. The aim of this study was to determine the prevalence of MRSA nasal carriage in pregnant women within the Hvidovre Hospital catchment area and to clarify if MRSA screening during pregnancy could prevent NICU outbreaks.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of MRSA nasal carriage among pregnant women in Copenhagen

et al. 2021

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Background Methicillin resistant Staphylococcus aureus (MRSA) frequently causes outbreaks in neonatal intensive care units (NICUs). It is believed that MRSA predominantly enters the NICU with MRSA colonized parents. In Denmark, 27 MRSA NICU outbreaks have been registered between 2008 and 2019. Aim The aim of this study was to determine the prevalence of MRSA nasal carriage in pregnant women in Copenhagen and to clarify if MRSA screening during pregnancy could add to the prevention of NICU outbreaks. Methods All pregnant women 18 years or older were offered MRSA nasal screening at their first midwife visit between 13 and 20 weeks of gestation. Results 1778 pregnant women were included, two (0.11%) carried MRSA in the nose. Conclusion Infants of the two MRSA positive women were not admitted to a NICU and therefore the screening had no impact on NICU outbreaks. The low prevalence of MRSA found in this study does not justify MRSA screening of all pregnant women in Denmark.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of MRSA nasal carriage among pregnant women in Copenhagen

et al. 2021

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“…It is widely recognized that the environment is a vector that facilitates the transmission of nosocomial pathogens. The environment become contaminated with bacteria shed by hospital staff, patients, and their relatives, and persist in the environment for months ( Kristinsdottir et al., 2019 ; Cruz-Lopez et al., 2020 ). Hospital staff and visitors are prone to touch these surfaces and, if contaminated, increase the risk of self-infection and transmission of pathogens to others ( Facciola et al., 2019 ).…”

Section: Introductionmentioning

confidence: 99%

MoWa: A Disinfectant for Hospital Surfaces Contaminated With Methicillin-Resistant Staphylococcus aureus (MRSA) and Other Nosocomial Pathogens

Gregory

Ellis

Valeriani

et al. 2021

Front. Cell. Infect. Microbiol.

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IntroductionStaphylococcus aureus strains, including methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA), are a main cause of nosocomial infection in the world. The majority of nosocomial S. aureus-infection are traced back to a source of contaminated surfaces including surgery tables. We assessed the efficacy of a mixture of levulinic acid (LA) and sodium dodecyl sulfate (SDS), hereafter called MoWa, to eradicate nosocomial pathogens from contaminated surfaces.Methods and ResultsA dose response study demonstrated that MoWa killed 24 h planktonic cultures of S. aureus strains starting at a concentration of (LA) 8.2/(SDS) 0.3 mM while 24 h preformed biofilms were eradicated with 32/1.3 mM. A time course study further showed that attached MRSA bacteria were eradicated within 4 h of incubation with 65/2 mM MoWa. Staphylococci were killed as confirmed by bacterial counts, and fluorescence micrographs that were stained with the live/dead bacterial assay. We then simulated contamination of hospital surfaces by inoculating bacteria on a surface prone to contamination. Once dried, contaminated surfaces were sprayed with MoWa or mock-treated, and treated contaminated surfaces were swabbed and bacteria counted. While bacteria in the mock-treated samples grew at a density of ~104 cfu/cm2, those treated for ~1 min with MoWa (1.0/0.04 M) had been eradicated below limit of detection. A similar eradication efficacy was obtained when surfaces were contaminated with other nosocomial pathogens, such as Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, or Staphylococcus epidermidis.ConclusionsMoWa kills planktonic and biofilms made by MRSA and MSSA strains and showed great efficacy to disinfect MRSA-, and MSSA-contaminated, surfaces and surfaces contaminated with other important nosocomial pathogens.

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A tale of two STs: molecular and clinical epidemiology of MRSA t304 in Norway 2008–2016

Enger

Larssen

Damås

et al. 2021

Eur J Clin Microbiol Infect Dis

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The purpose of this study was to investigate the epidemiological, molecular, and clinical characteristics of MRSA t304/ST8 and t304/ST6 in Norway from 2008 to 2016. Clinical and epidemiological data were collected for each case included in the study. Strains were characterized by PCR, spa typing, antimicrobial susceptibility testing, and whole genome sequencing. The overall number of cases of MRSA t304 increased from 27 in 2008 to 203 in 2016. Most MRSA t304/ST8 cases were defined as HA-MRSA (89.9%) and diagnosed in persons with Norwegian background, many of them living in nursing homes (62.3%). The number of t304/ST8 cases declined throughout the study period and it has not been reported in Norway since 2014. The increasing MRSA t304/ST6 genotype has mainly been introduced to Norway by immigration from the Middle East, but also from other parts of the world. The t304/ST6 clone is mostly classified as CA-MRSA (75.1%), does not seem to cause serious infections, is not multi-resistant, and has not yet caused outbreaks in Norway. This study provides an example of two MRSA clones with the same spa type found in different epidemiological settings. This is very unusual, but still a reminder that spa typing in some cases may have insufficient discriminatory power for surveillance of MRSA. Our results highlight the importance of active surveillance and characterization of emerging MRSA clones with high potential for spread in the community, which may potentially cause outbreaks in healthcare facilities.

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MRSA outbreak in a tertiary neonatal intensive care unit in Iceland

Cited by 9 publications

References 35 publications

Prevalence of MRSA nasal carriage among pregnant women in Copenhagen

Prevalence of MRSA nasal carriage among pregnant women in Copenhagen

MoWa: A Disinfectant for Hospital Surfaces Contaminated With Methicillin-Resistant Staphylococcus aureus (MRSA) and Other Nosocomial Pathogens

A tale of two STs: molecular and clinical epidemiology of MRSA t304 in Norway 2008–2016

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