Successful control of methicillin-resistant Staphylococcus aureus in a spinal cord injury center: a 10-year prospective study including molecular typing

Bacteriology of pressure ulcers in individuals with spinal cord injury: What we know and what we should know

“…56 In those with SCI and MRSA, the bacterium may typically be isolated from three or more body sites, but most frequently from pressure ulcers. 50,51,54 Wounds that are colonized with MRSA may remain colonized despite antibacterial treatment and other decolonization measures. 54,57 Not only has MRSA colonization been associated with prolonged hospital stays for individuals with SCI, but also the predisposition to the development of pressure ulcers and nosocomial infections.…”

“…51,52 Community-acquired MRSA is becoming more prevalent than MRSA acquisition from nosocomial transmission. 53,54 Previously, rates of colonization varied widely, and ranged from <5 to >70% of individuals with SCI in a hospital setting or specialized SCI center. 53,55 In 2013, MRSA was identified in 38.6% of individuals with SCI within 48 hours of admission to an acute care facility.…”

Are measures against MRSA transmission effective?

“…Dette fremgår av § 2-2 femte ledd. 60 Plikt til å varsle annen helseinstitusjon fremgår av MSIS-og tuberkuloseregisterforskriften § 3-8. 61 Plikt til å gi informasjon og personlig smittevernveiledning fremgår av smittevernloven § 2-1.…”

“…Behandlingsansvarlig lege i helseinstitusjon, som finner at en pasient som er overført fra en annen helseinstitusjon har MRSA, skal varsle lege ved den andre helseinstitusjonen dersom det er nødvendig av hensyn til smittevernet 60 . Se også kapittel 8.4 om meldingsplikt ved funn av MRSA og varslingsplikt ved utbrudd av smittsom sykdom.…”

Diagnostic Challenges inInfections related to Spinal Cord Injury

“…Multi drug resistant or multi-resistant bacteria have predilection to effect SCI units more than general nursing wards include MRSA (methicillin resistant Staphylococcus aureus),vancomycinresistantEnterococcus(VRE),gram-negative bacilli that produce extended spectrum β lactamase(ESBL),and clostridium defficile.Roommate contacts of patients colonized or infected by any of these multi-resistant bacteria are at increased risk for acquiring those organisms [48].Of these multi-resistant organisms,MRSA is the most common; it is responsible for a large share of both hospital and community-acquired infections [49].Unlike MRSA, which could exist in almost every body organ, VRE is cultured mostly from the urine, particularly catheter-dependent patients. Although most episodes growth of VRE from urine cultures represent asymptomatic bacteremia and do not require antibiotic treatment,VRE colonization and residence in a longterm facility increase the risk for subsequent bacteremia [50].Catheter-dependent SCI patients are predisposed to develop urinary tract infection caused by ESBL-producing multi-resistant gram -negative bacilli, such as E.coli,andKlebsiella pneumoniae [51].Researchers in Malaysia reported that SCI patients with previous UTI, antibiotic usage during the past three months or history of hospitalization during past one -year were predisposed to develop infection with multi-resistant organisms [30].The frequent administration of antibiotics and relatively inadequate hygiene in SCI patients help explain the high risk of clinical infection by C.defficle.In patients with neurogenic bowel and defective sensation C.defficile associated gastrointestinal disease can remain clinically undetected until a catastrophe such as toxic megacolon or bowel perforation evolve [52].…”