High prevalence of MRSA and multi-resistant gram-negative bacteria in refugees admitted to the hospital—But no hint of transmission

Abstract

With high numbers of refugees arriving in Europe uncertainty exists as to whether multidrug-resistant organisms are imported into the healthcare system. In our study, we identified 383 refugee-inpatients admitted to the University Hospital Münster, Germany between September 2015 and September 2016. For this patient cohort screening for Methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Gram-negative bacteria (MDR-GNB) and Vancomycin-resistant enterococci (VRE) was recommended in our institution. Until May 2016 pre-emptive isolation was applied to all refugee-inpatients until the exclusion of these multidrug-resistant organisms. MRSA were found in 34 refugee-patients (9.8%), MDR-GNB in 25 refugee-patients (12.9%) and VRE in none of the refugee patients. We did not find any strains carrying carbapenemases. Whole genome sequencing (WGS) data demonstrated that the respective isolates were genetically heterogeneous and revealed no transmission of refugee-patient isolates to other patients. We therefore omitted pre-emptive isolation as an infection control measure for this group of patients. Furthermore, molecular typing did not show evidence for nosocomial transmission from refugee-patients to other patients. Standard hygiene measures successfully prevented the transmission of refugee-patient isolates to other patients and as a result introduction into the healthcare system. This underlines that any multidrug-resistant organisms present within this cohort are not of any extraordinary concern for health systems.

Predominance of CTX-M-15-producing ST131 strains among ESBL-producingEscherichia coliisolated from asylum seekers in the Netherlands

“…A limited number of studies have previously sequenced MDROs in a refugee/asylum seeker patient population. 27 , 28 To our knowledge, this is the first study to investigate ESBL- E. coli strains isolated from asylum seekers using WGS on a large scale documenting various genetic characteristics, such as STs, genotypic resistance profiles and phylogenetic relatedness. This information is still scarce in the related literature and can help to optimize treatment, hospital hygiene strategies and infection control measures.…”

Special Aspects in Pediatric Surgical Inpatient Care of Refugee Children: A Comparative Cohort Study

“…This is in line with other studies which have found similar results. In one study of 383 minor refugees at the University of Münster [18], 9.8% were colonized with MRSA, and 12.9% were colonized with MRGN. In a screening study of 119 unaccompanied minor refugees in Frankfurt [19], Enterobacteriaceae with extended spectrum beta-lactamases (ESBL) were found in 35% of cases.…”

Status of Biofilm-Forming Genes among Jordanian Nasal Carriers of Methicillin-Sensitive and Methicillin-Resistant Staphylococcus aureus

“…In addition to its global impact, the development of resistant S. aureus strains is of particular importance in Jordan due to high rates of antimicrobial resistance emerged largely by antibiotic misuse practices and the recent increase in refugee (predominantly from Syria) numbers amongst whom the prevalence of resistant MRSA strains is relatively high [23,24] . These geopolitical events can largely affect the distribution of antibiotic-resistant bacteria, and a continuous assessment of infection, colonization, and antibiotic sensitivity profiles is required [25] .…”