Methicillin-Resistant Staphylococcus aureus Carriage in a Child Care Center Following a Case of Disease

Shahin, Rita; Johnson, Ian; Jamieson, Frances; McGeer, Alison; Tolkin, Jonathan; Ford-Jones, E. Lee

doi:10.1001/archpedi.153.8.864

Cited by 149 publications

(97 citation statements)

References 24 publications

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“…Of this group, 17 patients (85%) had nasal carriage. Others studied S. aureus carriage in a child care center [74]. Of 2,727 9 (252) 7 (198) 128 children who had swabs taken from nose, perineum, and throat, 8 (24%) had perineal carriage.…”

Section: Intestinal S Aureus Colonization and Disease Development Inmentioning

confidence: 99%

“…After identification of a single case of MRSA infection, 128 children from a child care center were assessed for MSSA/MRSA carriage by perianal, nasal, and throat swabs [74]. This analysis identified an additional MRSA carrier only from the perianal swab, whereas the two other sites were negative.…”

Section: Intestinal S Aureus Colonization and Disease Development Inmentioning

confidence: 99%

See 1 more Smart Citation

Intestinal carriage of Staphylococcus aureus: how does its frequency compare with that of nasal carriage and what is its clinical impact?

Acton¹,

Plat-Sinnige

Wamel

et al. 2008

Eur J Clin Microbiol Infect Dis

197

162

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The bacterial species Staphylococcus aureus, including its methicillin-resistant variant (MRSA), finds its primary ecological niche in the human nose, but is also able to colonize the intestines and the perineal region. Intestinal carriage has not been widely investigated despite its potential clinical impact. This review summarizes literature on the topic and sketches the current state of affairs from a microbiological and infectious diseases' perspective. Major findings are that the average reported detection rate of intestinal carriage in healthy individuals and patients is 20% for S. aureus and 9% for MRSA, which is approximately half of that for nasal carriage. Nasal carriage seems to predispose to intestinal carriage, but sole intestinal carriage occurs relatively frequently and is observed in 1 out of 3 intestinal carriers, which provides a rationale to include intestinal screening for surveillance or in outbreak settings. Colonization of the intestinal tract with S. aureus at a young age occurs at a high frequency and may affect the host's immune system. The frequency of intestinal carriage is generally underestimated and may significantly contribute to bacterial dissemination and subsequent risk of infections. Whether intestinal rather than nasal S. aureus carriage is a primary predictor for infections is still ill-defined.

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Section: Intestinal S Aureus Colonization and Disease Development Inmentioning

confidence: 99%

Section: Intestinal S Aureus Colonization and Disease Development Inmentioning

confidence: 99%

Intestinal carriage of Staphylococcus aureus: how does its frequency compare with that of nasal carriage and what is its clinical impact?

Acton¹,

Plat-Sinnige

Wamel

et al. 2008

Eur J Clin Microbiol Infect Dis

197

162

View full text Add to dashboard Cite

show abstract

“…1318 " 23 In addition, the subject is controversial and there is an ongoing polemic in the medical literature. Whereas some authors state that MRSA should be controlled because these organisms may soon become resistant to all antimicrobials and that infection control measures are beneficial, other authors suggest that the benefits of controlling MRSA are unclear because it is practically impossible to apply control measures and because attempts at controlling MRSA in healthcare facilities have failed.…”

Section: Discussionmentioning

confidence: 99%

“…13,18 ' 19 In addition, the recent emergence of community-acquired MRSA infections in Australia, Canada, France, and the United States will further complicate efforts to control MRSA. 20 " 23 The report of four pediatric deaths due to community-acquired MRSA demonstrates the potential severity of these infections. 21 Because of the continued emergence of multidrugresistant S. aureus, we considered it critical to assess the methods currently used by hospitals worldwide to control the emergence of MRSA The objectives of this survey were to assess (1) the methods used by laboratories to identify S. aureus and determine the susceptibility of this pathogen to antimicrobials, including methicillin; (2) the MRSA surveillance and control programs in these hospitals; and (3) the incidence of MRSA infections in hospitals worldwide.…”

mentioning

confidence: 99%

Are There Regional Variations in the Diagnosis, Surveillance, and Control of Methicillin-ResistantStaphylococcus aureus?

Richet

Benbachir

Brown

et al. 2003

Infect. Control Hosp. Epidemiol.

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OBJECTIVE:To assess the way healthcare facilities (HCFs) diagnose, survey, and control methicillin-resistant Staphylococcus aureus (MRSA).DESIGN: Questionnaire. SETTING: Ninety HCFs in 30 countries. RESULTS: Evaluation of susceptibility testing methods showed that 8 laboratories (9%) used oxacillin disks with antimicrobial content different from the one recommended, 12 (13%) did not determine MRSA susceptibility to vancomycin, and 4 (4.5%) reported instances of isolation of vancomycin-resistant S. aureus but neither confirmed this resistance nor alerted public health authorities. A MRSA control program was reported by 55 (61.1%) of the HCFs. The following isolation precautions were routinely used: hospitalization in a private room (34.4%), wearing of gloves (62.2%), wearing of gowns (44.4%), hand washing by healthcare workers (53.3%), use of an isolation sign on the patient's door (43%), or all four. When the characteristics of HCFs with low incidence rates (< 0.4 per 1,000 patient-days) were compared with those of HCFs with high incidence rates (s= 0.4 per 1,000 patient-days), having a higher mean number of beds per infection control nurse was the only factor significantly associated with HCFs with high incidence rates (834 vs 318 beds; P = .02).CONCLUSION: Our results emphasize the urgent need to strengthen the microbiologic and epidemiologic capacities of HCFs worldwide to prevent MRSA transmission and to prepare them to address the possible emergence of vancomycin-resistant S. aureus (Infect Control Hosp Epidemiol 2003;24:334-341).

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“…8 Throat culture is also associated with a sensitivity equal to or greater than that of nasal cultures to detect MRSA in select patient populations, such as children. 26,27 If used, the swab specimens from the throat and the nares can be plated onto the same agar plate, thus enhancing sensitivity without increasing culture cost.…”

Section: Several Studies In This Issue Of Infection Control and Hospitalmentioning

confidence: 99%

Methicillin-ResistantStaphylococcus aureusControl: We Didn't Start the Fire, but It's Time to Put It Out

Muto

2006

Infect. Control Hosp. Epidemiol.

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The prevalence of healthcare-associated infections (HAIs) caused by multidrug-resistant organisms has significantly increased over the past decade, according to the measurements of the Centers for Disease Control and Prevention, and will likely continue to climb. 1 ' 2 Currently, more than 70% of HAIs are caused by bacteria that are resistant to at least 1 of the drugs most commonly used to treat these infections. 3 These HAIs have been associated with increased cost and mortality, compared with infections due to antibiotic-susceptible strains of the same bacterial species. 4,5 Nevertheless, despite decades of studies confirming increased rates of adverse events related to these organisms and ongoing evidence of increased prevalence of multidrug-resistant organisms, 2 as well as the emergence of new antimicrobial-resistant organisms, 6 few coordinated effective efforts exist across the United States and most parts of the world to prevent MRSA transmission and reduce the number of MRSA HAIs. 7 Despite evidence of efficacy for control of multidrug-resistant organisms with active surveillance cultures and barrier precautions 8 " 10 and despite documented failure to control MRSA in studies lacking methods to fully identify the MRSA reservoir, 8 most healthcare systems have not elected to implement methods to identify and contain MRSA, and so MRSA continues to spread and to colonize and infect patients. Several studies in this issue of Infection Control and HospitalEpidemiology describe efforts to control methicillin-resistant S. aureus (MRSA). I comment here on 3 of them. 11 " 13 Interestingly, the investigators in these 3 studies believe that colonized patients represented a significant portion of the MRSA reservoir and elected to implement a program of active surveillance cultures to better identify MRSA-colonized patients. In two of the studies, that of Salgado and Farr 11 and that of Eveillard et al., 12 barrier precautions were implemented for all patients identified as being MRSA colonized, as recommended by the recent Society for Healthcare Epidemiology of America (SHEA) guideline. 8 The third study, by Sandri et al., 13 discusses the utility of MRSA decolonization of the nares by administration of topical mupirocin therapy and chlorhexidine baths to all patients identified as having MRSA colonization of the nares.The study by Salgado and Farr" reports the proportion of patients identified by active surveillance culture on admission as being MRSA colonized who later had an MRSA-positive clinical microbiology culture, the number and type of clinical microbiology cultures done, and the number and type of MRSA-positive clinical microbiology cultures. Their study demonstrates that only 15% of all patients identified as being colonized with MRSA on admission would have been so identified subsequently via clinical microbiology culture. When data for patients in the intensive care unit (ICU) and in other units (non-ICU patients) were analyzed separately, the investigators found that 21.4% of ICU patients had a subse...

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Methicillin-Resistant Staphylococcus aureus Carriage in a Child Care Center Following a Case of Disease

Cited by 149 publications

References 24 publications

Intestinal carriage of Staphylococcus aureus: how does its frequency compare with that of nasal carriage and what is its clinical impact?

Intestinal carriage of Staphylococcus aureus: how does its frequency compare with that of nasal carriage and what is its clinical impact?

Are There Regional Variations in the Diagnosis, Surveillance, and Control of Methicillin-ResistantStaphylococcus aureus?

Methicillin-ResistantStaphylococcus aureusControl: We Didn't Start the Fire, but It's Time to Put It Out

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