Staphylococcus aureus carriage and infections among patients in four haemo- and peritoneal-dialysis centres in Denmark

Zimakoff, J; Pedersen, F; Bergen, Linda; Baagø-Nielsen, J.; Daldorph, B.; Espersen, Frank; Hansen, Bente Gahrn; Høiby, Niels; Jepsen, Otto; Joffe, Preben; Kolmos, H J; Klausen, Mikkel; Kristoffersen, K.; Ladefoged, J; Olesen-Larsen, S.; Rosdahl, Vibeke Thamdrup; Scheibel, J.; Storm, Benjamin

doi:10.1016/s0195-6701(96)90015-8

Cited by 65 publications

(43 citation statements)

References 20 publications

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“…Previous studies have identified S. aureus carriage as a risk factor for bacteremia (22,23), but S. aureus carriage did not predict bacteremia in our study. Given the relatively short duration over which isolates were prospectively collected, one of the rationales for the inclusion of isolates associated with bacteremia from the 5-year period prior to the study was to include a potentially more genetically diverse bacterial population from the same setting.…”

Section: Discussioncontrasting

confidence: 97%

“…The renal unit setting was used because the prevalence of S. aureus carriage and the incidence of S. aureus bacteremia are reported in the published literature to be high (13,21,23). Our findings indicated that the levels of discrimination by MLST and PFGE were comparable if isolates are grouped into PFGE types on the basis of three or fewer band differences (corresponding to the closely related category in the criteria of Tenover et al [18]).…”

Section: Discussionmentioning

confidence: 59%

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Comparison of Multilocus Sequence Typing and Pulsed-Field Gel Electrophoresis as Tools for Typing Staphylococcus aureus Isolates in a Microepidemiological Setting

et al. 2002

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Multilocus sequence typing (MLST) of Staphylococcus aureus is well suited to the study of global or long-term epidemiology, but its role in local epidemiology has not been defined. The present study has compared MLST with pulsed-field gel electrophoresis (PFGE) by using S. aureus isolates associated with carriage and disease in a busy regional renal unit. One hundred forty-four patients were prospectively recruited, of whom 103 were receiving hemodialysis and 41 were on continuous ambulatory peritoneal dialysis. Three nasal swab specimens were obtained 1 month apart on entering the study. A nasal swab was positive for S. aureus on at least one occasion in 50 patients (35%). Typing of the 104 carriage isolates demonstrated 21 PFGE types and 21 sequence types (STs). Thirty-one carriers had two or more positive nasal swabs; of these, the isolates in all swabs from a given carrier had identical PFGE types for 29 carriers; the isolates in all of the same 29 swabs had identical STs. The carriage strain in two patients changed both PFGE type and STs during the period of swabbing. Eight patients (6%) had an episode of S. aureus bacteremia during the 12-month study period, and two of these were nasal carriers. One of these invasive isolates had the same PFGE type and ST as the carriage isolate. There were no differences between Simpson's index of diversity for PFGE and Simpson's index of diversity for MLST for both invasive and carriage isolates, suggesting that the two methods have very similar discriminatory abilities. We conclude that PFGE and MLST performed equally in this study.Molecular typing of the important human pathogen Staphylococcus aureus has been used to examine both long-term or global epidemiology and short-term or local epidemiology. Understanding the genetic structure of the global population over time gives insights into the evolution of bacterial lineages and transmission dynamics and also provides a framework with which to study bacterial pathogenesis. This contrasts with the typing of organisms in a defined setting over a short period of time which is used to study nosocomial outbreaks, local transmission and carriage, and the relationship between isolates associated with carriage and infection in a given individual.The attributes required of a typing tool vary depending on the application. For example, studies of nosocomial outbreaks caused by strains such as epidemic methicillin-resistant S. aureus strains are commonly performed in many centers; thus, cost, the technical expertise required, speed, reproducibility, and comparability between centers are all important issues. A range of different techniques have been described and evaluated, but pulsed-field gel electrophoresis (PFGE) is the predominant method in use for studies of outbreaks and local epidemiology (2,5,8,14,17,20). PFGE has also been successfully applied to isolates separated by geographical location (1), but it is generally considered overdiscriminatory for this type of study since the technique detects genetic variation that accum...

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Section: Discussioncontrasting

confidence: 97%

Section: Discussionmentioning

confidence: 59%

Comparison of Multilocus Sequence Typing and Pulsed-Field Gel Electrophoresis as Tools for Typing Staphylococcus aureus Isolates in a Microepidemiological Setting

et al. 2002

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“…The predominant risk factor for these patients is the presence of an intravascular access device and in particular the use of a cuffed, tunneled catheter (e.g., permacath) for dialysis (42). However, other host factors that result in an impairment of the host immune defense, including neutrophil dysfunction (43), iron overload (44), diabetes (45), and increased rates of colonization (45), may also increase the likelihood of invasive S. aureus infections. The infrequent vancomycin dosing strategy often used among hemodialysis-dependent patients may not maintain an adequate trough level in high-flux, large-poresize artificial kidneys (46)(47)(48), increasing the risk for relapsing SAB.…”

Section: Epidemiologymentioning

confidence: 99%

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

et al. 2015

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SUMMARY Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to β-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions.

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“…present on intact areas of the skin of certain patients can vary from 100 to 10 6 /cm 2 (25,29,31,33). Persons with diabetes, patients undergoing dialysis for chronic renal failure, and those with chronic dermatitis are likely to have areas of intact skin that are colonized with S. aureus (34)(35)(36)(37)(38)(39)(40)(41). Because approximately 10 6 skin squames containing viable microorganisms are shed daily from normal skin (42), patient gowns, bed linen, bedside furniture, and other objects in the patient's immediate environment can easily become contaminated with patient flora (30,(43)(44)(45)(46).…”

Section: Evidence Of Transmission Of Pathogens On Handsmentioning

confidence: 99%

The Effect of a Scenario based Hand Hygiene Education Program on Hand Hygiene Knowledge, Hand Hygiene Perception, Hand Hygiene Compliance and Hand Hygiene Method in Nursing Students<sup>*</sup>

Hwang¹,

Park²

2016

J Korean Acad Fundam Nurs

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Staphylococcus aureus carriage and infections among patients in four haemo- and peritoneal-dialysis centres in Denmark

Cited by 65 publications

References 20 publications

Comparison of Multilocus Sequence Typing and Pulsed-Field Gel Electrophoresis as Tools for Typing Staphylococcus aureus Isolates in a Microepidemiological Setting

Comparison of Multilocus Sequence Typing and Pulsed-Field Gel Electrophoresis as Tools for Typing Staphylococcus aureus Isolates in a Microepidemiological Setting

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

The Effect of a Scenario based Hand Hygiene Education Program on Hand Hygiene Knowledge, Hand Hygiene Perception, Hand Hygiene Compliance and Hand Hygiene Method in Nursing Students<sup>*</sup>

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