MRSA carriage: the relationship between community and healthcare setting. A studyin an Italian hospital

Scudeller, Luigia; Leoncini, Ornella; Boni, Stefano; Navarra, A.; Rezzani, Antonella; Verdirosi, Sandro; Maserati, Renato

doi:10.1053/jhin.2000.0806

Cited by 17 publications

(10 citation statements)

References 31 publications

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“…Another noteworthy observation is that colonized patients seemed more likely to have a malignancy, as reported in a few studies conducted both in long-term care facilities [19] and on screening at hospital admission [25]. Neither other clinical conditions (e.g., diabetes) nor the presence of invasive devices were found to be significantly associated with MRSA carriage.…”

Section: Discussionmentioning

confidence: 83%

“…We think that control strategies, including the isolation or the cohorting of colonized residents, should be chosen according to the local epidemiology. Our results may aid in the design of selective screening strategies that would offer high sensitivity at an affordable cost [35], limiting active surveillance to high-risk residents, such as those receiving frequent antibiotic treatments or those returning from hospital [3,25]. As a matter of fact, the contribution of antibiotics to the selection of multidrug-resistant microrganisms appears to be similar in both the nosocomial setting and the community [36], and the appropriate use of antibiotic treatment remains an area of great concern.…”

Section: Discussionmentioning

confidence: 99%

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Clustering and Risk Factors of Methicillin-Resistant Staphylococcus aureus Carriage in Two Italian Long-Term Care Facilities

et al. 2008

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The study suggests that nursing homes are a significant reservoir for MRSA. Statistical and PFGE analyses indicate a scenario where MRSA seems to be endemic and individual risk factors, namely recent hospitalizations and repeated antibiotic treatments, play a major role in the selection of drug-resistant organisms. Infection control measures should be coordinated among different health care settings, and the appropriate use of antibiotics has emerged as an important issue for improving the quality of care.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Clustering and Risk Factors of Methicillin-Resistant Staphylococcus aureus Carriage in Two Italian Long-Term Care Facilities

et al. 2008

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“…The definition of ''healthcareassociated infections'' (HCAI) has been proposed for infections occurring in patients living in the community and having contact with the healthcare system [70]. In European countries with high HA-MRSA rates, such as Italy or the UK, the majority of MRSA infections acquired in the community occur in patients with risk factors and are, in fact, HCAI [71][72][73][74].…”

Section: Mrsa In Healthcare-associated Infections and Healthcare-assomentioning

confidence: 99%

What is MRSA?

Pantosti¹,

Venditti²

2009

European Respiratory Journal

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For decades methicillin-resistant Staphylococcus aureus (MRSA) has been considered the prototype of multi-resistant nosocomial pathogens, causing infections in highrisk patients. Changes in the healthcare system, coupled with the evolution of this versatile microorganism, have transformed MRSA into a cause of community-onset infections, in both patients who have contact with the healthcare system and patients without such a risk factor.New lineages of MRSA, defined as community acquired (CA)-MRSA, have emerged that have a propensity to cause infections in young individuals without risk factors. CA-MRSA primarily causes skin infections and, rarely, necrotising pneumonia. In the USA, these strains belong to a single widespread clone, designated USA300, while in Europe they belong to a variety of clones. Most strains carry genes for the Panton-Valentine leukocidin, whose role in diseases is under debate.In subjects living in the community who have contact with the healthcare system, MRSA strains of the nosocomial type are a frequent cause of infection and of pneumonia in particular. The detection of a large MRSA reservoir in pigs and the finding that professionally exposed individuals are colonised, has further shown that it is necessary to closely follow the epidemiology of MRSA if we want to combat it effectively.

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“…The most common risk factors for the acquisition of MRSA include administration of multiple antibiotics [8,10] . In a study carried out in Italy, community-acquired nasal carriage was found to be very rare while referral to hospital or outpatient clinics and the history of hospitalization in the last six months had been detected as risk factors for MRSA carriage and spread through institutions [11] . In another study carried out in Turkey,…”

Section: Discussionmentioning

confidence: 99%

“…S. aureus nasal carriage and MRSA nasal carriage rates in inpatients and outpatients in various studies are shown in Table 4. Risk factors for MRSA infection and colonization include recent admission to the hospital, surgical intervention, intravenous drug use, underlying disease, close contact with hospital personnel, antibiotic use in the last six months, institutionalization and the presence of hospital personnel among family members [5,8,11,16] . In our study, hospital personnel, inpatients and outpatients were evaluated for risk factors for MRSA nasal carriage.…”

Section: Discussionmentioning

confidence: 99%

Nasal Carriage of Methicillin- Resistant Staphylococcus aureus and Risk Factors Amongst Inpatients, Outpatients and Hospital Personnel

Cesur¹,

Irmak²,

Yildiz³

et al. 2014

Mediterr J Infect Microb Antimicrob

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Introduction: The aim of this study was to determine the ratio of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) and the risk factors among 1500 subjects including 689 hospital staff, 609 inpatients, and 202 outpatients in Ankara Training and Research Hospital. Materials and Methods:Nasal swabs were obtained from hospital staff, inpatients and outpatients, which were then inoculatedinto mannitol-salt agar, oxacillin resistance screening agar base (ORSAB), and chromogenic MRSA agar media, respectively. Methicillin resistance was confirmed with cefoxitin disk by the disk-diffusion test. In statistical analyses, the Chi-square and the Kruskal Wall is tests were used, considering p< 0.05 value statistically significant.Results: MRSA nasal carriage rate was determined 3.03%, 9.03% and 3.96% in hospital staff, inpatients and outpatients, respectively. The rate of nasal carriage of MRSA amongst doctors, nurses and auxiliary health personnel was 1.36%, 1.735% and 5.06% respectively. [1][2][3] . It has been reported in many studies carried out in Turkey that the rate of MRSA infection varies between 37-71% [4] . MRSA usually spreads through direct contact with contaminated hands of health care workers; however, nasal carriage among hospital staff and inpatients may be accounted for some nosocomial MRSA infections [5] . Consequently, identification of patients and hospital staff colonized or infected with MRSA, subsequent isolation, and eradication of nasal carriage are necessary for the control of nosocomial MRSA infections [6][7][8] . NasalThe aim of this study was to determine the rate of nasal carriage of MRSA amongst hospital staff, inpatients, and outpatients. MATERIALS and METHODS Ethics StatementWritten informed consent was obtained from all patients, on whom the study was carried out in Ankara Training and Research Hospital. Information forms were prepared and the approval of the Ethics Committee was obtained from Ankara Training and Research Hospital. Patients and SamplesIn order to determine nasal carriage and risk factors (i.e. antibiotic use in the last six months, hospitalization or history of surgical operation in the previous year, and hospital stay) among hospital staff and patients hospitalized for surgery and/or in internal medicine clinics and intensive care units for more than one week, nasal swabs were taken from a total of one thousand five hundred subjects including 609 patients hospitalized for more than one week, 202 outpatients selected as the control group, and 689 hospital staff members. Laboratory StudyNasal swabs were inoculated into mannitol-salt agar (Oxoid, UK), oxacillin resistance screening agar (ORSAB, Oxoid, UK), and chromogenic MRSA agar Conclusion: Hospital staff,especially auxiliary health personnel, should be trained on hospital infections, routes of transmission, and protective measures. In addition, in clinics where MRSA infections and colonization is common, hospital staff and inpatients should be screened for MRSA nasal carriage at certain interv...

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MRSA carriage: the relationship between community and healthcare setting. A studyin an Italian hospital

Cited by 17 publications

References 31 publications

Clustering and Risk Factors of Methicillin-Resistant Staphylococcus aureus Carriage in Two Italian Long-Term Care Facilities

Clustering and Risk Factors of Methicillin-Resistant Staphylococcus aureus Carriage in Two Italian Long-Term Care Facilities

What is MRSA?

Nasal Carriage of Methicillin- Resistant Staphylococcus aureus and Risk Factors Amongst Inpatients, Outpatients and Hospital Personnel

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