Eradication of Methicillin-Resistant Staphylococcus aureus From a Health Center Ward and Associated Nursing Home

Kotilainen, Pirkko; Routamaa, Marianne; Peltonen, R; Evesti, Pirjo; Eerola, Erkki; Salmenlinna, Saara; Vuopio‐Varkila, Jaana; Rossi, T

doi:10.1001/archinte.161.6.859

Cited by 79 publications

(62 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Mupirocin calcium ointment is a topical antibiotic indicated for the eradication of nasal carriage of staphylococci, including methicillin-resistant strains. Mupirocin alone or in combination with other antimicrobial agents decreases S. aureus colonization among residents of LTCFs (3,7,8,20). Several outbreaks of methicillin-resistant S. aureus colonization and infection in LTCFs have been reported, and until now, it was thought that the application of mupirocin ointment might help break the chain of transmission.…”

mentioning

confidence: 99%

Clonal Dissemination and mupA Gene Polymorphism of Mupirocin-Resistant Staphylococcus aureus Isolates from Long-Term-Care Facilities in South Korea

Yoo¹,

Shin²,

Ok³

et al. 2006

Antimicrob Agents Chemother

View full text Add to dashboard Cite

We identified 25 high-level mupirocin-resistant (MuH) and 21 low-level mupirocin-resistant (MuL) Staphylococcus aureus isolates from eight long-term-care facilities (LTCFs). The pulsed-field gel electrophoresis patterns of 19 MuH and 19 MuL isolates from two facilities were identical for 18 and 15 isolates, respectively. The most predominant mupA restriction fragment length polymorphism type was found in 21 MuH isolates. We conclude that clonal transmission of MuH and MuL S. aureus strains occurred in these LTCFs. This is the first report of clonal transfer of mupirocin resistance in LTCFs.Colonization and infection with Staphylococcus aureus are common in older people in long-term-care facilities (LTCFs) (1, 2, 4). The prevalence of S. aureus colonization and infection, which result primarily from methicillin-resistant strains, has recently been reported by chronic care facilities worldwide (1,3,6,7). Mupirocin calcium ointment is a topical antibiotic indicated for the eradication of nasal carriage of staphylococci, including methicillin-resistant strains. Mupirocin alone or in combination with other antimicrobial agents decreases S. aureus colonization among residents of LTCFs (3,7,8,20). Several outbreaks of methicillin-resistant S. aureus colonization and infection in LTCFs have been reported, and until now, it was thought that the application of mupirocin ointment might help break the chain of transmission. However, the extensive use of this agent has led to the rapid emergence of mupirocinresistant strains in different parts of the world (9,16,11,13,18,19). To our knowledge, there are no reports on the prevalence and outbreak of mupirocin-resistant S. aureus in LTCFs. In South Korea, mupirocin ointment has been used since 1994 to eradicate staphylococcal infection in hospitals, and the prevalence and mechanisms of mupirocin-resistant staphylococci were first reported in 2003 (23).We investigated the clonal transmission of high-level mupirocin-resistant (MuH) and low-level mupirocin-resistant (MuL) S. aureus and the mupA gene polymorphisms of MuH S. aureus strains in LTCFs. Seven hundred forty-nine swab specimens were obtained from patients of eight LTCFs from July to August 2002. Nasal swab specimens were obtained from 632 patients (one isolate per patient), and 117 infection swab samples were obtained from infected sites (e.g., sore, wound, or trachea) present in these patients. Swab specimens were cultured on staphylococcal broth (Trypticase soy broth [TSB]) medium for 24 h at 35°C. Mannitol salt agar and mannitol salt oxacillin agar supplemented with 6 g/ml oxacillin were used to isolate S. aureus and methicillin-resistant S. aureus, respectively. Initial identification was based on colony morphology, Gram staining, the coagulase test using the Staphaureux latex agglutination kit (Murex Biotech Ltd., Dartford, United Kingdom), and thermonuclease production with DNase medium (Becton Dickinson, Franklin Lakes, NJ). When necessary, further confirmatory tests were performed using a Vitek system (bioMerieux,...

show abstract

mentioning

confidence: 99%

Clonal Dissemination and mupA Gene Polymorphism of Mupirocin-Resistant Staphylococcus aureus Isolates from Long-Term-Care Facilities in South Korea

Yoo¹,

Shin²,

Ok³

et al. 2006

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…17 Various earlier studies in non-SCI collectives demonstrated the efficacy of rigorous infection control measures to prevent intra-hospital spread of MRSA. 9 In a recent study 18 performed in a country with low MRSA incidence, even eradication of the pathogen has been reported. In Switzerland, where overall low rates of MRSA are still observed, endemic MRSA, present in southern and south-western regions, appears to result from continuous introduction of new strains from surrounding southern countries.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2007

View full text Add to dashboard Cite

“…In contrast, screening high risk patients for the presence of MRSA followed by implementation of isolation or barrier precautions for those found to be infected or colonized has been shown to be effective in controlling MRSA outbreaks in hospitals and long term care facilities (115)(116)(117)(118)(119), and in reducing nosocomial transmission and overall prevalence in facilities where MRSA is endemic (11,110,(120)(121)(122)(123)(124)(125). Jernigan et al (118,121) reported a 15-fold decrease in transmission of MRSA in a hospital when colonized patients were recognized by a screening program and then cared for with isolation precautions, compared with when isolation precautions were used only in patients recognized to have MRSA from clinical specimens.…”

Section: Screening and Surveillancementioning

confidence: 99%

The Management of Infection and Colonization due to Methicillin‐Resistant Staphylococcus aureus: A CIDS/CAMM Position Paper

Simor

Loeb²

2004

Canadian Journal of Infectious Diseases and Medical Microbiolog

View full text Add to dashboard Cite

Methicillin-resistantStaphylococcus aureus(MRSA) is being seen with greater frequency in most hospitals and other health care facilities across Canada. The organism may cause life-threatening infections and has been associated with institutional outbreaks. Several studies have confirmed that MRSA infection is associated with increased morbidity and mortality compared with infections caused by susceptible strains, even when the presence of comorbidities is accounted for. Treatment of MRSA infection is complicated by the fact that these organisms are resistant to multiple antimicrobial agents, so treatment options are limited. The effectiveness of decolonization therapy (attempting to eradicate MRSA carriage) is also uncertain. This paper reviews the medical management of MRSA infections, discusses the potential role of decolonization and provides an overview of evidence to support recommended infection control practices.

show abstract

Eradication of Methicillin-Resistant Staphylococcus aureus From a Health Center Ward and Associated Nursing Home

Cited by 79 publications

References 23 publications

Clonal Dissemination and mupA Gene Polymorphism of Mupirocin-Resistant Staphylococcus aureus Isolates from Long-Term-Care Facilities in South Korea

Clonal Dissemination and mupA Gene Polymorphism of Mupirocin-Resistant Staphylococcus aureus Isolates from Long-Term-Care Facilities in South Korea

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

The Management of Infection and Colonization due to Methicillin‐Resistant Staphylococcus aureus: A CIDS/CAMM Position Paper

Contact Info

Product

Resources

About