Molecular Characterization of the Transmission between the Colonization of Methicillin-resistant Staphylococcus aureus to Human and Environmental Contamination in Geriatric Long-term Care Wards

Asoh, Norichika; Masaki, Hironori; Watanabe, Hiroshi; Watanabe, Kiwao; Mitsusima, Hiroaki; Matsumoto, Kazutsugu; Oishi, Kazunori; Nagatake, Tsuyoshi

doi:10.2169/internalmedicine.44.41

Cited by 31 publications

(29 citation statements)

References 25 publications

(26 reference statements)

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“…Altogether, the frequency of MRSA positive environmental sites was 60.4%. Other studies on this topic have reported lower contamination rates in isolation rooms, such as 27.0% (19) , 24.0% (23) , 40.0% (24) , 22.0% (20) , and 54.0% (21) . However, the various studies of MRSA detection on surfaces in isolation rooms are hardly comparable, since the patient characteristics, the microbiological screening methods, the sampling regimen, as well as the manner, frequency, and effectiveness of cleaning and disinfection methods vary considerably.…”

Section: Discussionmentioning

confidence: 82%

Methicillin-resistant Staphylococcus aureus on surfaces of an Intensive Care Unit

Ferreira

Andrade

Rigotti³

et al. 2011

Acta paul. enferm.

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Objective: To evaluate the presence of methicillin-resistant Staphylococcus aureus (MRSA) in areas close to patients in a General Intensive Care Unit. Methods: This is a cross-sectional study, in which microbiological samples were collected from five surfaces (left / right bed siderails, bed crank, table, buttons on the infusion pump, and cotton gowns) from each of ten patient rooms, totaling 63 samples. To collect samples, the Petri Film TM Staph Express Count System 3M TM was used to screen for methicillin resistance, with the Mueller-Hinton agar supplemented with 4% sodium chloride and 6 μg / ml of oxacillin. Descriptive analysis was conducted to determine the frequency (n) and percentage (%) of contamination of environmental surfaces. Results: Of 48 samples positive for Staphylococcus aureus, 29 (60.4%) were resistant to methicillin. The incidence on the siderails and bed cranks, table, buttons on the infusion pumps and aprons were, respectively, 55.5%, 57.1%, 57.1%, 60.0% and 75.0%. Conclusion:The results suggest that the surfaces around the patient constitute a major threat, as they represent secondary reservoirs of MRSA. Keywords: Staphylococcus aureus; Equipment contamination; Cross infection; Methicillin resistance RESUMOObjetivo: Avaliar a presença de Staphylococcus aureus resistente à meticilina (MRSA) em superfícies próximas aos pacientes internados em uma Unidade de Terapia Intensiva Geral. Métodos: Trata-se de um estudo transversal, no qual foram coletadas amostras microbiológicas de cinco superfícies (grades direita/esquerda, manivela da cama, mesa, botões da bomba de infusão e aventais de algodão) de cada dez unidades de pacientes, totalizando 63 amostras. Para a coleta, foram utilizadas placas Petri Film TM Staph Express Count System 3M TM e para a triagem de resistência à meticilina, o ágar Mueller-Hinton adicionado de 4% de cloreto de sódio e 6 μg/ml oxacilina. Análises descritivas foram empregadas para determinar a frequência (n) e porcentagem (%) de contaminação das superfícies ambientais. Resultados: Das 48 amostras positivas para Staphylococcus aureus, 29 (60,4%) foram resistentes à meticilina. A incidência em grades e manivelas da cama, mesa, botões da bomba de infusão e aventais foi, respectivamente, 55,5%, 57,1%, 57,1%, 60,0% e 75,0%. Conclusão: Os resultados sugerem que as superfícies ao redor do paciente constituí-se uma importante ameaça, visto que representam reservatórios secundários de MRSA. Descritores: Staphylococcus aureus; Contaminação de equipamentos; Infecção hospitalar; Resistência à meticilina RESUMEN Objetivo: Evaluar la presencia de Staphylococcus aureus resistente a la meticilina (MRSA) en superficies cercanas a los pacientes internados en una Unidad de Cuidados Intensivos General. Métodos: Se trata de un estudio transversal, en el cual se recolectaron muestras microbiológicas de cinco superficies (enrejados derecho/izquierdo, manivela de la cama, mesa, botones de la bomba de infusión y mandiles de algodón) de cada diez unidades de pacientes, totalizando 63 mues...

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Section: Discussionmentioning

confidence: 82%

Methicillin-resistant Staphylococcus aureus on surfaces of an Intensive Care Unit

Ferreira

Andrade

Rigotti³

et al. 2011

Acta paul. enferm.

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“…Fifty-seven strains were from the patients’ environment. Molecular typing by PFGE with the Sma I restriction enzyme demonstrated that the predominant type of MRSA isolated from the environment changed by the minute [5]. …”

Section: Methodsmentioning

confidence: 99%

Significant Reduction of Nosocomial Pneumonia after Introduction of Disinfection of Upper Airways Using Povidone-Iodine in Geriatric Wards

Masaki¹,

Nagatake

Asoh

et al. 2006

Dermatology

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We investigated the efficacy of disinfection of the upper airway using povidone-iodine against nosocomial pneumonia in geriatric wards. Cases of nosocomial pneumonia were retrospectively analyzed between January 1991 and March 1995 in geriatric wards (190 beds). Moreover, the relationship concerning methicillin-resistant Staphylococcus aureus (MRSA) isolates between patient and environment was investigated using pulsed-field gel electrophoresis (PFGE) with the SmaI restriction enzyme. The incidence of nosocomial pneumonia decreased significantly (p < 0.05). Major causative organisms of nosocomial pneumonia were MRSA and Pseudomonas aeruginosa, which significantly decreased. PFGE studies showed that the patterns of MRSA isolates show a strong association between patient and environment. Our study indicates that disinfection of the upper airways by povidone-iodine is very important in the prevention of nosocomial pneumonia in geriatric wards.

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“…(Weese, J.S., 2007) discusses a number of additional possible methods for screening of the environment of animals for MRSA including the use of contact plates, swabs, electrostatic cloths, passive and active air sampling. These sampling methods were successfully used to detect MRSA in human environments (Asoh, N. et al, 2005;Shiomori, T. et al, 2001) however there is limited information on the effectiveness and sensitivity of these methods in the environment of production animals with very high loads of bacteria and dust. Other approaches included the inoculation of broth solutions with feed material or faeces and the preparation of suspensions of bedding material (Lee, J.H., 2003;Lu, J. et al, 2003).…”

Section: Sampling For Diagnosis Of Mrsa Contamination In the Environmentmentioning

confidence: 99%

“…Skin to skin contact is probably the main route of transmission between humans, humans to animals, animals to human and between animals, however contaminated materials, surfaces, food or dust can play also a role in transmitting the agent (Asoh, N. et al, 2005;Lee, J.H., 2003). This is true for both HA-MRSA and CA-MRSA.…”

Section: Vectors For Transmission Of Mrsamentioning

confidence: 99%

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2009

EFSA Journal

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SUMMARYThe European Food Safety Authority (EFSA) asked its Panel on Biological Hazards to deliver a scientific opinion on: The assessment of the Public Health significance of meticillin resistant Staphylococcus aureus (MRSA).There are different states of interaction between S. aureus and its host: infections, carriage or colonisation, and contamination. Meticillin resistant S. aureus (MRSA) can be persistently or intermittently carried by healthy humans, and colonisation is the major risk factor for infection. Infection can be mild to severe and, in some instances, fatal. MRSA are now a major cause of hospital acquired infection in many European countries, with large differences in prevalence and control policies. A limited number of lineages of MRSA tend to predominate in specific geographical locations. CC398 is the MRSA lineage most often associated with asymptomatic carriage in intensively reared food-producing animals. MRSA commonly carry enterotoxin genes but there has been only one report of food intoxication due to MRSA. On the question on what is the risk to human health posed by MRSA associated with foodproducing animals, the Panel concluded that:Livestock-associated MRSA (LA-MRSA) represent only a small proportion of the total number of reports of MRSA infections in the EU. However, this proportion differs between Member States. In some countries with low prevalence of human MRSA infection, CC398 is a major contributor to the overall MRSA burden. In countries with high overall human MRSA prevalence, CC398 is considered of less significance for the public health. CC398 has, albeit rarely, been associated with deep-seated infections of skin and soft tissue, pneumonia and septicaemia in humans. Where CC398 prevalence is high in food-producing animals, people in contact with these live animals (especially farmers and veterinarians, and their families) are at greater risk of colonisation and infection than the general population. The risk to human health from different levels (dose response) of MRSA during carriage in animals (and in the environment) is not known. On the question of what is the importance of food, food-producing animals, and companion animals in the risk of human infection and/or food-borne disease caused by MRSA in both the community and hospital settings, the Panel concluded that:Food may be contaminated by MRSA (including CC398): eating and handling contaminated food is a potential vehicle for transmission. There is currently no evidence for increased risk of human colonisation or infection following contact or consumption of food contaminated by CC398 both in the community and in hospital. MRSA (including CC398) can enter the slaughterhouse in or on animals and occurs on raw meat. Although it may become part of the endemic flora of the slaughterhouse, the risk of infection to slaughterhouse workers and persons handling meat appears to be low based on currently available data.Where CC398 prevalence is high in food-producing animals, people in direct contact with these live animals (espe...

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Molecular Characterization of the Transmission between the Colonization of Methicillin-resistant Staphylococcus aureus to Human and Environmental Contamination in Geriatric Long-term Care Wards

Abstract: Objective Transmission between human and environmental contamination from colonized methicillin-resistant Staphylococcus aureus (MRSA) remains a controversial issue. We, therefore, investigated the differences between MRSA types which colonize in humans and in the environment.Methods

Cited by 31 publications

References 25 publications

Methicillin-resistant Staphylococcus aureus on surfaces of an Intensive Care Unit

Methicillin-resistant Staphylococcus aureus on surfaces of an Intensive Care Unit

Significant Reduction of Nosocomial Pneumonia after Introduction of Disinfection of Upper Airways Using Povidone-Iodine in Geriatric Wards

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