Control of Epidemic Methicillin-Resistant Staphylococcus aureus

Murray-Leisure, Katherine A.; Geib, Sandra; Graceley, Diane; Rubin-Slutsky, Arline B.; Saxena, Narendra; Muller, H. Arnold; Hamory, Bruce H.

doi:10.2307/30144277

Cited by 42 publications

(13 citation statements)

References 40 publications

(25 reference statements)

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“…These other interventions may have played a significant role in controlling these outbreaks. One report mentioned the complete control of an outbreak when only simple infection control measures were taken (67), while several others found that only extensive modification of local infection control practices were effective (16,25,91,130). Therefore, infection control measures should be accompanied by identification of carriers and, subsequently, elimination of S. aureus carriage (213).…”

Section: Mrsamentioning

confidence: 99%

Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks

1997

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Staphylococcus aureus has long been recognized as an important pathogen in human disease. Due to an increasing number of infections caused by methicillin-resistant S. aureus (MRSA) strains, therapy has become problematic. Therefore, prevention of staphylococcal infections has become more important. Carriage of S. aureus appears to play a key role in the epidemiology and pathogenesis of infection. The ecological niches of S. aureus are the anterior nares. In healthy subjects, over time, three patterns of carriage can be distinguished: about 20% of people are persistent carriers, 60% are intermittent carriers, and approximately 20% almost never carry S. aureus. The molecular basis of the carrier state remains to be elucidated. In patients who repeatedly puncture the skin (e.g., hemodialysis or continuous ambulatory peritoneal dialysis [CAPD] patients and intravenous drug addicts) and patients with human immunodeficiency virus (HIV) infection, increased carriage rates are found. Carriage has been identified as an important risk factor for infection in patients undergoing surgery, those on hemodialysis or CAPD, those with HIV infection and AIDS, those with intravascular devices, and those colonized with MRSA. Elimination of carriage has been found to reduce the infection rates in surgical patients and those on hemodialysis and CAPD. Elimination of carriage appears to be an attractive preventive strategy in patients at risk. Further studies are needed to optimize this strategy and to define the groups at risk.

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Section: Mrsamentioning

confidence: 99%

Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks

1997

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“…When used during an outbreak, active surveillance cultures have been convincingly demonstrated to interrupt the spread of both VRE 37,41-49 and MRSA. [50][51][52][53][54][55] The evidence supporting the use of active surveillance cultures for the control of antimicrobialresistant bacteria in circumstances other than during an outbreak is more limited. 36,[56][57][58][59][60][61][62][63][64][65][66][67] Most of the available reports describe surveillance programs applied to high-risk units (such as ICUs and dedicated wards for immunocompromised patients) or specific populations of high-risk hospital patients (such as long-term care facility residents or hemodialysis patients).…”

Section: Clinical Effectiveness Of Active Surveillance Cultures and Imentioning

confidence: 99%

Legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci: Position statement from the Joint SHEA and APIC Task Force

Weber

Huang

Oriola³

et al. 2007

American Journal of Infection Control

136

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Legislation aimed at controlling antimicrobial-resistant pathogens through the use of active surveillance cultures to screen hospitalized patients has been introduced in at least 2 US states. In response to the proposed legislation, the Society for Healthcare Epidemiology of America (SHEA) and the Association for Professionals in Infection Control and Epidemiology, Inc., (APIC) have developed this joint position statement. Both organizations are dedicated to combating health care-associated infections with a wide array of methods, including the use of active surveillance cultures in appropriate circumstances. This position statement reviews the proposed legislation and the rationale for use of active surveillance cultures, examines the scientific evidence supporting the use of this strategy, and discusses a number of unresolved issues surrounding legislation mandating use of active surveillance cultures. The following 5 consensus points are offered. (1) Although reducing the burden of antimicrobial-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), is of preeminent importance, the APIC and the SHEA do not support legislation to mandate use of active surveillance cultures to screen for MRSA, VRE, or other antimicrobial-resistant pathogens. (2) The SHEA and the APIC support the continued development, validation, and application of efficacious and cost-effective strategies for the prevention of infections caused by MRSA, VRE, and other antimicrobial-resistant and antimicrobial-susceptible pathogens. (3) The APIC and the SHEA welcome efforts by health care consumers, together with private, local, state, and federal policy makers, to focus attention on and formulate solutions for the growing problem of antimicrobial resistance and health care-associated infections. (4) The SHEA and the APIC support ongoing additional research to determine and optimize the appropriateness, utility, feasibility, and cost-effectiveness of using active surveillance cultures to screen both lower-risk and high-risk populations. (5) The APIC and the SHEA support stronger collaboration between state and local public health authorities and institutional infection prevention and control experts.

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“…In July 1997, on the basis of the available literature, [16][17][18][19][20] we introduced a program to control nosocomial MRSA transmission within the hospital of Cremona using a multicomponent approach similar to the search and isolate system. 21 The key points of the program were:…”

Section: Interventionmentioning

confidence: 99%

Trends in Methicillin-ResistantStaphylococcus aureus(MRSA) Bloodstream Infections: Effect of the MRSA “Search and Isolate” Strategy in a Hospital in Italy with Hyperendemic MRSA

Pan

Carnevale

Catenazzi

et al. 2005

Infect. Control Hosp. Epidemiol.

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Control of Epidemic Methicillin-Resistant Staphylococcus aureus

Cited by 42 publications

References 40 publications

Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks

Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks

Legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci: Position statement from the Joint SHEA and APIC Task Force

Trends in Methicillin-ResistantStaphylococcus aureus(MRSA) Bloodstream Infections: Effect of the MRSA “Search and Isolate” Strategy in a Hospital in Italy with Hyperendemic MRSA

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