Methicillin-Resistant Staphylococcus aureus (MRSA) Nares Colonization at Hospital Admission and Its Effect on Subsequent MRSA Infection

Davis, Kepler A.; Stewart, Justin J.; Crouch, Helen K.; Florez, Christopher E.; Hospenthal, Duane R.

doi:10.1086/422997

Cited by 538 publications

(345 citation statements)

References 34 publications

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“…This rate is comparable with rates reported elsewhere. 1,29 Older age, intensive care unit stay, receipt of hemodialysis, presence of surgical wounds, presence of pressure ulcers, and use of intravascular catheters have been associated with an increased progression of MRSA colonization to invasive infection. 1,29 ' 30 In our study, a higher number of risk factors at the end of follow-up was associated with an increased risk of MRSA infection.…”

Section: Mrsa Infection During Follow-upmentioning

confidence: 99%

Duration of Methicillin-Resistant Staphylococcus aureus Carriage, According to Risk Factors for Acquisition

Marschall

Mühlemann

2006

Infect. Control Hosp. Epidemiol.

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OBJECTIVE. To examine the duration of methicillin-resistant Staphylococcus aureus (MRSA) carriage and its determinants and the influence of eradication regimens. DESIGN. Retrospective cohort study. SETTING. A 1,033-bed tertiary care university hospital in Bern, Switzerland, in which the prevalence of methicillin resistance among S. aureus isolates is less than 5%. . Failure of decolonization treatment was associated with the presence of risk factors at the time of treatment (P = .01). Intermittent screenings that were negative for MRSA were frequent (26% of patients), occurred early after first detection of MRSA (median, 31.5 days), and were associated with a lower probability of clearing colonization (HR, 0.34 [95% CI,) and an increased risk of MRSA infection during follow-up.CONCLUSIONS. Risk factors for MRSA acquisition should be carefully assessed in all MRSA carriers and should be included in infection control policies, such as the timing of decolonization treatment, the definition of MRSA clearance, and the decision of when to suspend isolation measures.

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Section: Mrsa Infection During Follow-upmentioning

confidence: 99%

Duration of Methicillin-Resistant Staphylococcus aureus Carriage, According to Risk Factors for Acquisition

Marschall

Mühlemann

2006

Infect. Control Hosp. Epidemiol.

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“…5,6 Previous studies 2,7,8 indicated that colonization with MRSA was a risk factor for subsequent infections such as bacteremia, pneumonia, and skin and soft tissue infections. However, in another study, 9 MRSA colonization was a poor predictor of LRTI and bloodstream infection (BSI) due to MRSA that required antimicrobial therapy.…”

mentioning

confidence: 99%

Nasal Colonization and Lower Respiratory Tract Infections with Methicillin-Resistant Staphylococcus aureus

Tilahun

Faust

McCorstin

et al. 2014

American Journal of Critical Care

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Background Methicillin-resistant Staphylococcus aureus is a cause of lower respiratory tract infections, particularly health care-and ventilator-associated pneumonia. Although many health systems use nasal screening for this microorganism for infection control, correlation between nasal carriage of the organism and development of infections due to it is not clear. Methods Records of patients admitted to medical intensive care between January 1, 2011, and December 31, 2012, were reviewed retrospectively. Patients' data were included if the patients were 18 years or older, satisfied clinical criteria for pneumonia, and had both nasal swabbing and culturing of respiratory specimens within 24 hours of admission. Results A total of 165 patients met the inclusion criteria. Most had either community-acquired or health care-associated pneumonia. Of the 28 patients with a nasal swab positive for methicillinresistant S aureus, 8 (4.8%) also had respiratory tract cultures positive for the microorganism. Among the 165 patients, 2 (1.2%) had negative nasal swabs but positive respiratory cultures. Sensitivity and specificity of nasal colonization with methicillinresistant S aureus for subsequent infection with the pathogen were 80% and 87.1%, respectively; positive and negative predictive values were 28.6% and 98.5%, respectively. Conclusions Nasal screening for methicillin-resistant S aureus may be a valuable tool for de-escalation of empiric therapy targeted to the organism, especially in patients admitted for severe community-acquired or health care-associated pneumonia. The high negative predictive value suggests that patients with a negative nasal swab most likely do not have a lower respiratory tract infection caused by the organism.

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“…2,3 Nasal colonization with S. aureus predisposes to subsequent infection, particularly in surgical patients. [4][5][6] Infections caused by methicillin-resistant S. aureus (MRSA) have been associated with increased mortality and hospital costs, compared with methicillin-susceptible strains. [7][8][9] Unidentified MRSA carriers serve as a potential reservoir for transmission.…”

mentioning

confidence: 99%

Epidemiology of Methicillin-Resistant Staphylococcus aureus Colonization in a Surgical Intensive Care Unit

Warren

Guth

Coopersmith

et al. 2006

Infect. Control Hosp. Epidemiol.

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of methicillin-resistant Staphylococcus aureus colonization in a surgical intensive care unit." Infection Control and Hospital Epidemiology. 27,10. 1032-1040. (2006 http://www.jstor.org/page/info/about/policies/terms.jsp JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. The University of Chicago Press andThe Society for Healthcare Epidemiology of America are collaborating with JSTOR to digitize, preserve and extend access to Infection Control and Hospital Epidemiology.

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Methicillin-Resistant Staphylococcus aureus (MRSA) Nares Colonization at Hospital Admission and Its Effect on Subsequent MRSA Infection

Cited by 538 publications

References 34 publications

Duration of Methicillin-Resistant Staphylococcus aureus Carriage, According to Risk Factors for Acquisition

Duration of Methicillin-Resistant Staphylococcus aureus Carriage, According to Risk Factors for Acquisition

Nasal Colonization and Lower Respiratory Tract Infections with Methicillin-Resistant Staphylococcus aureus

Epidemiology of Methicillin-Resistant Staphylococcus aureus Colonization in a Surgical Intensive Care Unit

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