Rates of Carriage of Methicillin-Resistant and Methicillin-Susceptible <i>Staphylococcus aureus</i> in an Outpatient Population

Kenner, Julie R.; O'Connor, Tasha; Piantanida, Nicholas A.; Fishbain, Joel T.; Eberly, Bardwell; Viscount, Helen B.; Uyehara, Catherine F. T.; Hospenthal, Duane R.

doi:10.1086/502229

Cited by 98 publications

(91 citation statements)

References 37 publications

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“…The overall nasal carriage rate of SA of 30.3% in our study population was within the range of nasal carriage rates reported in other studies [5,13,15]. The Centers for Disease Control and Prevention reports approximately 25% to 30% of the United States population is colonized with SA based on epidemiologic evaluations compiled since the 1950s [5].…”

Section: Discussionsupporting

confidence: 82%

“…However, the overall rate of MRSA in our orthopaedic population of 1.8% was somewhat higher than the 0.8% reported by Kuehnert et al [15]. In another study, MSSA colonization was present in 153 (38%) of the 404 asymptomatic outpatients, and MRSA colonization was present in eight (2%) [13]. Thus preoperative orthopaedic outpatient colonization rates with MSSA and MRSA in our study population seem to reflect the rates of the general population from other studies during similar periods.…”

Section: Discussioncontrasting

confidence: 62%

“…MRSA, the prevalence of which has been increasing in the community, is believed to add to the burden of SA colonization [13,15]. Therefore, we sought to determine the prevalence of asymptomatic nasal colonization with SA, including MRSA, among healthy preoperative orthopaedic surgery outpatients at an urban hospital.…”

Section: Discussionmentioning

confidence: 99%

“…The Centers for Disease Control and Prevention reports approximately 25% to 30% of the United States population is colonized with SA based on epidemiologic evaluations compiled since the 1950s [5]. Studies from recent years trend toward higher reported rates [13,15]. In a nationally representative US survey of noninstitutionalized individuals 1 year or older, the prevalence of SA nasal colonization was 32.4% in 2001-2002 [15].…”

Section: Discussionmentioning

confidence: 99%

“…Methicillin-resistant Staphylococcus aureus (MRSA) in the community is believed to add to the burden of SA colonization, and its prevalence is increasing [13]. Furthermore, Ellis et al reported a 3.1-fold risk (95% confidence interval, 1.5-6.5) for acquiring MRSA infection in MRSA carriers compared with noncarriers [7].…”

Section: Introductionmentioning

confidence: 99%

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Staphylococcus aureus Nasal Colonization in Preoperative Orthopaedic Outpatients

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Williams

Philips

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Nasal colonization with Staphylococcus aureus (SA) increases the risk of surgical site infection (SSI). We first (1) determined the prevalence of asymptomatic nasal colonization with SA, (2) assessed trends in methicillin resistance with time, (3) ascertained risk factors for nasal colonization; and (4) correlated SSI to nasal colonization status and procedure. We performed a cross-sectional analysis of SA nasal colonization among healthy preoperative orthopaedic outpatients between 2003-2005 who were within 2 weeks of surgery. Of 284 patients, 86 (30%) carried SA; of these, 81 (94%) were colonized with methicillin-sensitive and five (6%) with methicillin-resistant SA (MRSA). Total SA colonization increased from 25/ 78 (32%) in 2003 to 37/97 (38%) in 2005, and colonization with MRSA increased from 0/78 (0%) to four of 97 (4%), respectively. We found no associations between nasal carriage and demographics or procedures. Surgical site infection occurred in nine of 282 (3%), four of which were attributable to SA; these included 0/43 (0%) carriers who received decolonization with 2% mupirocin, two of 43 (4.7%) who declined decolonization, and two of 196 (1.0%) who were noncarriers. Nasal colonization with SA, including MRSA, among preoperative orthopaedic outpatients is increasing and their rates reflect community rates. Knowledge of colonization status may be important in decolonization, choosing perioperative or any subsequent empiric antibiotics.

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Section: Discussionsupporting

confidence: 82%

Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Staphylococcus aureus Nasal Colonization in Preoperative Orthopaedic Outpatients

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Williams

Philips

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Prevalence and characteristics of methicillin‐resistant Staphylococcus aureus in community residents of Japan

Yamasaki

Takeuchi

Uehara

et al. 2018

J of Gen and Family Med

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BackgroundTo implement effective precautions to avoid methicillin‐resistant Staphylococcus aureus (MRSA) nosocomial infections, it is important to clarify when, how, and from whom MRSA was transmitted to the patients. However, MRSA strains obtained from outpatient population were not analyzed, and the transmission routes of MRSA in the community are not completely understood. The purpose of this study was to clarify whether MRSA is spreading in community settings or whether MRSA transmission still occurs only in healthcare institutions.MethodsSurveillance cultures of 1274 residents living in a community were performed in two different areas, Kochi and Osaka prefectures of Japan. All isolated MRSA strains were evaluated using multilocus sequence typing (MLST) to clarify the transmission routes of MRSA. The results were compared with those of inpatients. Moreover, written questionnaires and medical records were analyzed.ResultsAnalysis of surveillance cultures from residents living in the community in Japan revealed an MRSA colonization rate of 0.94%. The proportion of MRSA to S. aureus colonization was 2.6% in the 310 residents, which was significantly lower than in the 393 hospitalized patients (63.1%; P < .0001). MRSA strains in residents are different from the endemic strains in the hospitalized patients. Previous hospital admission is a risk factor for MRSA infection of the endemic strain in hospital.ConclusionsMethicillin‐resistant Staphylococcus aureus colonization in community setting is rare in Japan. MLST results suggest that some MRSA strains are moving to the community through previous hospital admissions; however, MRSA is not spreading in community settings.

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Mitigation and Education

2014

Journal Orthopaedic Research

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Rates of Carriage of Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus in an Outpatient Population

Cited by 98 publications

References 37 publications

Staphylococcus aureus Nasal Colonization in Preoperative Orthopaedic Outpatients

Staphylococcus aureus Nasal Colonization in Preoperative Orthopaedic Outpatients

Prevalence and characteristics of methicillin‐resistant Staphylococcus aureus in community residents of Japan

Mitigation and Education

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