Aerial dispersal of meticillin-resistant Staphylococcus aureus in hospital rooms by infected or colonised patients

Gehanno, Jean-François; Louvel, A; Nouvellon, M.; Caillard, J. F.; Pestel-Caron, Martine

doi:10.1016/j.jhin.2008.11.015

Cited by 65 publications

(42 citation statements)

References 22 publications

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“…Indeed, a nasal carrier can disperse S. aureus into the air and was identified as the possible cause of a nosocomial outbreak (Sherertz et al 1996). In addition, the presence of airborne MRSA has been found to be significantly related to the presence of MRSA-infected or -colonized patients (Wilson et al 2004;Gehanno et al 2009). In recent years, several studies have investigated airborne MRSA using different samplers, including the Andersen 1-STG impactor (Hsiao et al 2012;Chang and Wang 2014), SAS 100 impactor (Agnoletti et al 2014), AES air sampler (Creamer et al 2014), and AGI-30 impinger .…”

Section: Introductionmentioning

confidence: 99%

Optimization of Propidium Monoazide Quantitative PCR for Evaluating Performances of Bioaerosol Samplers for Sampling AirborneStaphylococcus aureus

Tseng

Hsiao

Chang

et al. 2014

Aerosol Science and Technology

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Airborne Staphylococcus aureus causes a significant proportion of nosocomial infections. The purpose of this study was to combine real-time quantitative polymerase chain reaction with the DNA-binding agent propidium monoazide (PMA-qPCR) to assess exposures to airborne S. aureus. In this work, we generated a S. aureus aerosol and used our assay to detect viable, airborne S. aureus in a study chamber. The biological collection efficiencies of three samplers (the AGI-30 impinger, BioSampler, and Nuclepore filter sampler) were evaluated using the S. aureus aerosols. The effects of storage in collection fluid on S. aureus sampled by the AGI-30 impinger and BioSampler were evaluated. Furthermore, air samples from an intensive care unit (ICU) and a gymnasium (GYM) were subsequently used to test the performance of a BioSampler combined with our PMA-qPCR technique. The BioSampler was more effective than the AGI-30 and Nuclepore filter samplers for preserving the culturability and viability of S. aureus aerosol samples. After sampling by impingement, the loss of viable S. aureus was minimized by treating the cells with PMA prior to storage at ¡20 C and analyzing the samples by qPCR within 3 weeks. In field applications, we noted that traditional culture assays tended to underestimate the viable concentrations of S. aureus by approximately one order of magnitude. Overall, combining qPCR with and without PMA staining may be useful for assessing exposure to airborne S. aureus. However, a complex set of parameters that may affect the efficiency of PMA-qPCR must be taken into account before applying PMA-qPCR to bioaerosol detection.

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Section: Introductionmentioning

confidence: 99%

Optimization of Propidium Monoazide Quantitative PCR for Evaluating Performances of Bioaerosol Samplers for Sampling AirborneStaphylococcus aureus

Tseng

Hsiao

Chang

et al. 2014

Aerosol Science and Technology

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“…Our results and those reported by Shiomori et al 34 appeared very low compared to a similar study by Shehabi and Baadran 35 who reported that MRSA comprised 42% of total isolated S. aureus from Jordanian ICU patients. Similarly, these numbers are very low compared to the numbers reported by Gehanno et al 13 who reported that 49% of air samples contained MRSA. The number of microorganisms in some sensitive hospital areas such as OT, ICU and NICU is usually low because the high sanitary standards are applied there as compared to other hospital areas, so that the programmed monitoring of microorganisms in these sensitive hospital units is very important to control the hospital-acquired infections.…”

Section: Distribution Of Mrs and Their Antibiotic Susceptibilitymentioning

confidence: 57%

“…Staphylococci, including MRSA can survive the dry conditions and can persist for long time in hospitals and areas that are inadequately cleaned. 13 MRSA can survive on surfaces or skin scales for up to 80 days. 14 The survivability of S. aureus depends on many factors including time and other atmospheric pollutants such as sulphur dioxide and carbon monoxide.…”

Section: Introductionmentioning

confidence: 99%

Airborne methicillin-resistantStaphylococcus aureusin the indoor environment of King Abdullah University Hospital, Jordan

Saadoun

Jaradat

Tayyar

et al. 2014

Indoor and Built Environment

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Methicillin-resistant Staphylococcus aureus (MRSA) is seen with increasing frequency in hospitals and is considered as a major cause of hospital-acquired infection. The objectives of this study were to isolate and characterize the airborne MRSA in different wards of a referral university hospital. Thirtyfour air samples of 100 litres volume/min were collected by a microbiological air sampler, then impacted on trypticase soy agar (TSA) and incubated at 37 C for 48 h. Recovered colonies were identified by standard methods. From all S. aureus, 9.3% was identified as MRSA which comprised 4.2%, 3.1% and 2% in the adult and nursery intensive care units, and operating theatres (ICU, NICU and OT, respectively). MRSA isolates were remarkably susceptible (87.1%) to each of amikacin, chloramphenicol, imipenem and rifampin. MRSA isolates were shown in all units with minimum inhibitory concentration value of >256, 32 and 6 mg/l in ICU, OT and NICU, respectively. Polymerase chain reaction analysis of all MRSA isolates indicated the amplification of the mec A gene. It is concluded that MRSA was isolated from all units making eradication of MRSA a target hard to achieve. However, the antibiotic resistance profile of the MRSA isolates looks promising leaving a room to combat nosocomial infections.

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“…MRSA are most often found near carriers. (Gehanno, J. et al, 2009) found MRSA of the same genotype in infected and colonised patients in a hospital and in the air of the room of these patients.…”

Section: Hospitalsmentioning

confidence: 89%

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2009

EFSA Journal

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SUMMARYThe European Food Safety Authority (EFSA) asked its Panel on Biological Hazards to deliver a scientific opinion on: The assessment of the Public Health significance of meticillin resistant Staphylococcus aureus (MRSA).There are different states of interaction between S. aureus and its host: infections, carriage or colonisation, and contamination. Meticillin resistant S. aureus (MRSA) can be persistently or intermittently carried by healthy humans, and colonisation is the major risk factor for infection. Infection can be mild to severe and, in some instances, fatal. MRSA are now a major cause of hospital acquired infection in many European countries, with large differences in prevalence and control policies. A limited number of lineages of MRSA tend to predominate in specific geographical locations. CC398 is the MRSA lineage most often associated with asymptomatic carriage in intensively reared food-producing animals. MRSA commonly carry enterotoxin genes but there has been only one report of food intoxication due to MRSA. On the question on what is the risk to human health posed by MRSA associated with foodproducing animals, the Panel concluded that:Livestock-associated MRSA (LA-MRSA) represent only a small proportion of the total number of reports of MRSA infections in the EU. However, this proportion differs between Member States. In some countries with low prevalence of human MRSA infection, CC398 is a major contributor to the overall MRSA burden. In countries with high overall human MRSA prevalence, CC398 is considered of less significance for the public health. CC398 has, albeit rarely, been associated with deep-seated infections of skin and soft tissue, pneumonia and septicaemia in humans. Where CC398 prevalence is high in food-producing animals, people in contact with these live animals (especially farmers and veterinarians, and their families) are at greater risk of colonisation and infection than the general population. The risk to human health from different levels (dose response) of MRSA during carriage in animals (and in the environment) is not known. On the question of what is the importance of food, food-producing animals, and companion animals in the risk of human infection and/or food-borne disease caused by MRSA in both the community and hospital settings, the Panel concluded that:Food may be contaminated by MRSA (including CC398): eating and handling contaminated food is a potential vehicle for transmission. There is currently no evidence for increased risk of human colonisation or infection following contact or consumption of food contaminated by CC398 both in the community and in hospital. MRSA (including CC398) can enter the slaughterhouse in or on animals and occurs on raw meat. Although it may become part of the endemic flora of the slaughterhouse, the risk of infection to slaughterhouse workers and persons handling meat appears to be low based on currently available data.Where CC398 prevalence is high in food-producing animals, people in direct contact with these live animals (espe...

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Aerial dispersal of meticillin-resistant Staphylococcus aureus in hospital rooms by infected or colonised patients

Cited by 65 publications

References 22 publications

Optimization of Propidium Monoazide Quantitative PCR for Evaluating Performances of Bioaerosol Samplers for Sampling AirborneStaphylococcus aureus

Optimization of Propidium Monoazide Quantitative PCR for Evaluating Performances of Bioaerosol Samplers for Sampling AirborneStaphylococcus aureus

Airborne methicillin-resistantStaphylococcus aureusin the indoor environment of King Abdullah University Hospital, Jordan

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