Transmission and Long-Term Colonization Patterns of Staphylococcus aureus in a Nursing Home

Kasela, Martyna; Grzegorczyk, Agnieszka; Korona-Głowniak, Izabela; Ossowski, Mateusz; Nowakowicz-Dębek, Bożena; Malm, Anna

doi:10.3390/ijerph17218073

Cited by 6 publications

(4 citation statements)

References 34 publications

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“…Our present data show that the geographic area of our study (an ~50 km-radius area in southeast Michigan including the Detroit metropolitan area, its suburbs, and semi-rural locations at its outskirts) broadly fits into this pattern. A seasonal increase in MRSA colonization has recently been observed in a NH in Europe ( 12 ), as well as in healthy young populations ( 13 ). Reports from settings other than NHs are still very much relevant to NHs due to increased risk of introduction, especially in view of the current trends of diminishing length of stay and increase of resident turnover and new admissions.…”

Section: Discussionmentioning

confidence: 99%

Seasonal Patterns in Incidence and Antimicrobial Resistance of Common Bacterial Pathogens in Nursing Home Patients and Their Rooms

Cassone

Mantey

Gontjes

et al. 2021

Front. Public Health

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Background: Colonization is the main precursor to infection, which may lead to adverse clinical outcomes among older adults in nursing homes (NHs). Understanding seasonal changes in the local burden of common bacterial pathogens is key to implementing appropriate and cost-effective infection prevention measures in this resource-constrained healthcare environment. It is thus surprising that seasonal trends in patient and environmental colonization with major bacterial pathogens are presently unknown in the expanding NH setting.Methods: We examined the seasonal incidence of four major pathogens among 640 nursing home patients and high-touch surfaces within their rooms over 2 years. In cases where a significant number of antimicrobial-resistant strains was found, incidence in antimicrobial-susceptible and antimicrobial-resistant isolates was compared, along with antibiotic use trends.Results: We observed spring peaks in the incidence of vancomycin-resistant enterococci (1.70 peak to trough ratio for both patient and environmental isolates) and methicillin-resistant Staphylococcus aureus (1.95 peak to trough ratio for patient isolates, 1.50 for environmental isolates). We also observed summer peaks in Klebsiella pneumoniae (1.83 and 1.82 peak to trough ratio for patient and environmental isolates, respectively), and ciprofloxacin-resistant Escherichia coli. Susceptible S. aureus and E. coli did not follow seasonal patterns.Conclusions: A meaningful seasonal pattern may be present in the NH setting for several significant pathogens, and especially antimicrobial-resistant ones. Whether such patterns are consistent across geographic areas and over longer periods of time should be a key focus of investigation, in order to better inform timing of surveillance and infection prevention efforts in this setting.

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Section: Discussionmentioning

confidence: 99%

Seasonal Patterns in Incidence and Antimicrobial Resistance of Common Bacterial Pathogens in Nursing Home Patients and Their Rooms

Cassone

Mantey

Gontjes

et al. 2021

Front. Public Health

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“…Microbiological sampling was performed quarterly during the year 2018 for almost all of the participants (92/101). The technique of collecting the samples as well as the methods used for identification of S. aureus and the detection of methicillin resistance were described in detail previously [ 40 ]. The study was approved by the Bioethics Committee at the Medical University of Lublin, Poland (KE 0254/59/2016).…”

Section: Methodsmentioning

confidence: 99%

The Prevalence of Virulence Determinants and Antibiotic Resistance Patterns in Methicillin—Resistant Staphylococcus aureus in a Nursing Home in Poland

et al. 2021

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Nursing homes (NH) contribute to the regional spread of methicillin-resistant Staphylococcus aureus (MRSA). Moreover, residents are vulnerable to the colonization and subsequent infection of MRSA etiology. We aimed at investigating the molecular and phenotypic characteristics of 21 MRSA collected from the residents and personnel in an NH (Lublin, Poland) during 2018. All MRSA were screened for 20 genes encoding virulence determinants (sea-see, eta, etb, tst, lukS-F-PV, eno, cna, ebpS, fib, bbp, fnbA, fnbB, icaADBC) and for resistance to 18 antimicrobials. To establish the relatedness and clonal complexes of MRSA in NH we applied multiple-locus variable-number tandem-repeat fingerprinting (MLVF), pulse field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and staphylococcal cassette chromosome mec (SCCmec) typing. We identified four sequence types (ST) among two clonal complexes (CC): ST (CC22) known as EMRSA-15 as well as three novel STs—ST6295 (CC8), ST6293 (CC8) and ST6294. All tested MRSA were negative for sec, eta, etb, lukS-F-PV, bbp and ebpS genes. The most prevalent gene encoding toxin was sed (52.4%; n = 11/21), and adhesins were eno and fnbA (100%). Only 9.5% (n = 2/21) of MRSA were classified as multidrug-resistant. The emergence of novel MRSA with a unique virulence and the presence of epidemic clone EMRSA-15 creates challenges for controlling the spread of MRSA in NH.

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“…Over the years, the MRSA colonization rate, producing infections, has dramatically increased among different populations, the most susceptible being children and elderly >85 years of age. 10 , 11 As such, active screening of MRSA strains has become both necessary and urgent. In this study, we demonstrated that the active screening of nasal vestibular swabs in ICU patients can successfully achieve early detection, early intervention, and early treatment of hospitalized patients.…”

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Hospitalized Patients in Eastern Heilongjiang Province, China

Yang¹,

Zhao²,

Wang³

et al. 2021

IDR

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Background Recently, owing to antibiotic resistance, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonization among intensive care unit (ICU) patients has increased rapidly. So far, there are few studies on active screening of MRSA. The purpose of the current study was to verify the effectiveness of active screening and analyze the molecular epidemiological characteristics of MRSA in the region. Methods We collected 30 samples of the MRSA strains from a tertiary hospital in the Eastern Heilongjiang Province. Among them, 7 were retrieved through nasal vestibular swabs at the emergency ICU and 23 were obtained from clinical specimens. Additionally, relevant patient medical information was examined retrospectively and molecular epidemiology and risk factor analysis for MRSA were performed. Results Molecular epidemiology studies revealed that all strains of bacteria carried the mecA resistance gene. The Panton Valentine leukocidin (PVL), for instance, was detected at a rate of 13.33% (4/30). The Staphylococcus aureus protein A (spa) types, found amongst our samples, were mainly t324, t437, t034, etc., and we discovered a new spa type t19702. We also revealed 3 types of SCCmec, namely, SCCmec type II, SCCmec type IVa, and SCCmec type V, with the most prevalent clonotypes being ST72 and ST59. In addition, we also found 7 new ST types, namely, ST6567, ST6568, ST6569, ST6570, ST6571, ST6572, and ST6573. Using risk factor analysis, we also demonstrated that long, invasive procedures used in the ICU, such as tracheal intubation and ventilator usage, along with patients with cerebral infarction and other embolism are more susceptible to developing MRSA colonization and further infections. Conclusion We recommend the infection control department within hospitals to actively screen for MRSA and perform risk factor analysis in order to establish accurate preventive measures for controlling MRSA spread.

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Transmission and Long-Term Colonization Patterns of Staphylococcus aureus in a Nursing Home

Cited by 6 publications

References 34 publications

Seasonal Patterns in Incidence and Antimicrobial Resistance of Common Bacterial Pathogens in Nursing Home Patients and Their Rooms

Seasonal Patterns in Incidence and Antimicrobial Resistance of Common Bacterial Pathogens in Nursing Home Patients and Their Rooms

The Prevalence of Virulence Determinants and Antibiotic Resistance Patterns in Methicillin—Resistant Staphylococcus aureus in a Nursing Home in Poland

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Hospitalized Patients in Eastern Heilongjiang Province, China

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