Nosocomial Staphylococcus aureus bacteremia among nasal carriers of methicillin-resistant and methicillin-susceptible strains

Pujol, Miquel; Peña, Carmen; Pallarés, Román; Ariza, Javier; Ayats, Josefina; Domı́nguez, M.A.; Gudiol, Francesc

doi:10.1016/s0002-9343(96)00014-9

Cited by 263 publications

(148 citation statements)

References 34 publications

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“…Furthermore, in the intervention and postintervention groups respectively, 22.0% and 26.9% of patients were found to have become positive in the first week of admittance to the ICU, which shows the high risk of nasal MRSA acquisition in an endemic situation. MRSA nasal carriers rates rang from 5.6% to 12.9% in ICU patients [5,10,23], such rates being lower than the ones found in our study. As yet, little is known about the MRSA nasal carrier epidemiology in ICU patients or its subsequent clinical consequences, since few in-depth investigations have been made.…”

Section: Discussioncontrasting

confidence: 90%

“…Pujol et al, in an ICU study, concluded that S. aureus nasal carriers are at a high risk for the development of bacteremia by the microorganism and suggest that treatment of those patients may be effective in controlling the agent [10].…”

Section: Discussionmentioning

confidence: 99%

“…There are evidence that MRSA nasal carriers contribute towards the development of infections by such agent, in critically ill patientes [10], such evidence including decreased infection rates by the microorganism after treatment of narecolonized patients [5,9,11]. Mupirocin topic antibiotic of excellent antibacterial activity against S. aureus, including MRSA, is currently deemed the drug of choice for decolonization [12,13], although its long-term use may give rise to resistant strains.…”

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confidence: 99%

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Efficacy of a program of prevention and control for methicillin-resistant Staphylococcus aureus infections in an intensive-care unit

et al. 2007

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Methicillin-resistant Staphylococcus aureus (MRSA) is endemic in most Brazilian Hospitals, and there are few studies which show the efficacy of control measures in such situations. This study evaluated intensive care unit (ICU) patients, in two years divided in control, intervention and post-intervention group. Intervention measures: hands-on educational programs for healthcare workers; early identification of MRSA infected or colonized patients, labeled with a bed-identification tag for contact isolation; nasal carriers, patients, and healthcare professionals treated with topical mupirocin for five days. The hospital infection rates in the control period were compared to the ones in the post-intervention period. Hospital infection rates were found by means of the NNISS methodology The incidence coefficients of MRSA hospital infection (monthly average of 1,000 pts/day) in the control, intervention and post-intervention groups were respectively: 10.2, 5.1 and 2.5/1,000 pts/day (p<0.001) and MRSA-originated bloodstream infections were 3.6, 0.9 and 1.8/1,000 central venous catheter/day (p=0.281). Nasal colonization in both intervention and post-intervention periods was of 30.9% and 22.1% among the hospitalized patients, respectively 54.4% and 46.1% of whom were already MRSA-positive when admitted to the unit. In the intervention period, most of those MRSA infected patients (76.2%) were nasal carrier. Mortality rates were, respectively 26.6%; 27.3% and 21.0% (p<0.001). Nasal carriers, both patients (93.7%) and healthcare professionals (88.2%), were successfully treated with topical mupirocin. Intervention measures for the prevention and control of MRSA infections in ICUs, have been efficient in the reduction of the bloodstream and MRSA-originated hospital infections incidence, and reduced the overall mortality rate significantly.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Efficacy of a program of prevention and control for methicillin-resistant Staphylococcus aureus infections in an intensive-care unit

et al. 2007

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“…[8][9][10] Importantly, MRSA carriage is associated with a fourfold increased infection risk compared with MSSA colonization. 11,12 Many studies have evaluated the risk factors for nosocomial MRSA acquisition (eg, comorbidities, exogenous factors, and antimicrobial exposure) to improve preventive measures, [13][14][15] but despite 50 years of research, less is known about the protective factors at the host level. It has been hypothesized that endogenous MSSA carriage may protect against exogenous MRSA acquisition by competing for colonization of the anterior nares.…”

Section: Does Colonization With Methicillin-susceptiblementioning

confidence: 99%

Does Colonization with Methicillin-Susceptible Staphylococcus aureus Protect against Nosocomial Acquisition of Methicillin-Resistant S. aureus?

Landelle

Iten

Uçkay

et al. 2014

Infect. Control Hosp. Epidemiol.

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OBJECTIVE: To test the hypothesis that methicillin-susceptible Staphylococcus aureus (MSSA) carriage may protect against nosocomial methicillin-resistant S. aureus (MRSA) acquisition by competing for colonization of the anterior nares. DESIGN: Prospective cohort and nested case-control study. SETTING: Swiss university hospital. PATIENTS: All adult patients admitted to 14 wards of the general medicine division between April 1 and October 31, 2007. METHODS: Patients were screened for MRSA and MSSA carriage at admission to and discharge from the division. Associations between nosocomial MRSA acquisition and MSSA colonization at admission and other confounders were analyzed by univariable and multivariable analysis. RESULTS: Of 898 patients included, 183 (20%) were treated with antibiotics. Nosocomial MRSA acquisition occurred in 70 (8%) of the patients (case patients); 828 (92%) of the patients (control subjects) were free of MRSA colonization at discharge. MSSA carriage at admission was 20% and 21% for case patients and control subjects, respectively. After adjustment by multivariate logistic regression, no association was observed between MSSA colonization at admission and nosocomial MRSA acquisition (adjusted odds ratio [aOR], 1.2 [95% confidence interval (CI), 0.6-2.3]). By contrast, 4 independent predictors of nosocomial MRSA acquisition were identified: older age (aOR per 1-year increment, 1.05 [95% CI, 1.02-1.08]); increased length of stay (aOR per 1-day increment, 1.05 [95% CI, 1.02-1.09]); increased nursing workload index (aOR per 1-point increment, 1.02 [95% CI, 1.01-1.04]); and previous treatment with macrolides (aOR, 5.6 [95% CI, JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.

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“…Approximately 20% of all patients undergoing surgery acquires at least one nosocomial infection (15,10). It has been estimated that nasal carriers of S. aureus are most at risk to develop nosocomial infections, especially if seropositives, cirrhotic, dialysised (haemo-and peritoneal dialysis), liver grafted hospitalized in surgery and intensive care units (14,8). Infected and colonized patients are the reservoir of MRSA, and the main way of transmission from patient to patient is represented by health care workers.…”

Section: Introductionmentioning

confidence: 99%

Utilization of the chromogenic agar MRSA ID in the surveillance of methicillin-resistant Staphylococcus aureus in a low endemic unit for MRSA

Squarzon¹,

Tessari²,

Paccagnella³

et al. 2008

Microbiol Med

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SUMMARYMethicillin-resistant Staphylococcus aureus (MRSA) is one of the most common pathogen responsible for nosocomial infections.Approximately 20% of patients undergoing surgical operations acquires at least one nosocomial infection. Nasal carriers of S. aureus have been identified as one of the populations at major risk to develop this type of infection, particularly, after operations, dialysis, transplants and admission in intensive care unit. Our study was conducted on patients who came from a Neurosurgery Intensive Care Unit, where the incidence of MRSA is very low (8%) and where it is very important to identify MRSA carriers in order to adopt measures to avoid transmission.The use of chromogenic agar MRSA ID allowed us to identify green colonies of MRSA within 24 hours and to make a timely and careful diagnosis.

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Nosocomial Staphylococcus aureus bacteremia among nasal carriers of methicillin-resistant and methicillin-susceptible strains

Cited by 263 publications

References 34 publications

Efficacy of a program of prevention and control for methicillin-resistant Staphylococcus aureus infections in an intensive-care unit

Efficacy of a program of prevention and control for methicillin-resistant Staphylococcus aureus infections in an intensive-care unit

Does Colonization with Methicillin-Susceptible Staphylococcus aureus Protect against Nosocomial Acquisition of Methicillin-Resistant S. aureus?

Utilization of the chromogenic agar MRSA ID in the surveillance of methicillin-resistant Staphylococcus aureus in a low endemic unit for MRSA

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