Overcrowding and understaffing in modern health-care systems: key determinants in meticillin-resistant Staphylococcus aureus transmission

Clements, Archie; Halton, Kate; Graves, Nicholas; Pettitt, Anthony N.; Morton, Anthony; Looke, David; Whitby, Michael

doi:10.1016/s1473-3099(08)70151-8

Cited by 189 publications

(137 citation statements)

References 130 publications

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“…In Australia, there are approximately 200,000 cases of HAI annually with a resultant loss of an estimated two million bed days (Cruickshank & Ferguson, 2008). The rapid increase in HAI rates has been attributed to a number of factors including increasing antibiotic resistance, overcrowding of hospitals and poor compliance with infection prevention and control precautions by healthcare workers (Clements et al, 2008;Gammon & Gould, 2005). Cross-infection of patients by HCWs with contaminated hands remains a significant driver of HAIs (Burke, 2003) and it is widely recognised that appropriately applied infection control precautions, particularly hand hygiene, can effectively reduce the rate of HAIs in healthcare settings (Harbarth, Sax, & Gastmeier, 2003).…”

Section: Infection Control -Why It Mattersmentioning

confidence: 99%

“…A variety of factors such as understaffing (Clements et al, 2008), skin irritation by hand-hygiene agents such as antiseptic hand washes (Huggonet & Pittet, 2000) and misconceptions about microbiological principles (Prieto & Clark, 2005) have been cited in the literature as barriers to compliance with infection control policies. Compliance is also likely to be influenced by professional attitudes and beliefs, perceived risk of infection, and workplace culture (DeJoy, Gershon, & Schaffer, 2004;Mutha et al, 1999;Whitby, McLaws, & Ross, 2006).…”

Section: Infection Control -Why It Mattersmentioning

confidence: 99%

See 1 more Smart Citation

Re-thinking microbiology/infection control education to enhance the practice-readiness of health professional students: More than just a curriculum issue

Cox

Simpson

Letts

et al. 2015

JLD

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Section: Infection Control -Why It Mattersmentioning

confidence: 99%

Section: Infection Control -Why It Mattersmentioning

confidence: 99%

Re-thinking microbiology/infection control education to enhance the practice-readiness of health professional students: More than just a curriculum issue

Cox

Simpson

Letts

et al. 2015

JLD

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“…Hospital overcrowding and understaffing has resulted in the inability to adapt services to the varying number of patient admissions and available staff, 61 and has led to the failure of MRSA control programs due to decreased HCW hand-hygiene compliance, increased movement of patients and staff between hospital wards, decreased levels of cohorting and overburdening of screening and isolation facilities. In turn, a high MRSA incidence increases hospital stay and bed blocking, which leads to overcrowding and a vicious cycle characterized by further failure of infection control.…”

Section: Hospital Overcrowding and Understaffingmentioning

confidence: 99%

“…In turn, a high MRSA incidence increases hospital stay and bed blocking, which leads to overcrowding and a vicious cycle characterized by further failure of infection control. 61 Recommendations for the control of hospital overcrowding and understaffing:…”

Section: Hospital Overcrowding and Understaffingmentioning

confidence: 99%

Prevention strategies for methicillin-resistant Staphylococcus aureus (MRSA) in Latin America

Labarca¹,

Salles²

2010

Braz J Infect Dis

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After the first reports of the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in the 1970s, numerous measures intended to prevent its transmission were initiated in hospitals. However, in most cases, large-scale measures failed to be implemented and the transmission of MRSA has since led to a global pandemic. Presently, doubts still remain about the best approach to prevent and control MRSA and more often than not, control measures are not implemented. Therefore, we review here the current situation in Latin America with respect to existing policies for control of MRSA, and evaluate the evidence for control measures in hospitals and the community. We look at the risk factors for infection and transmission of MRSA between hospital patients and within specific populations in the community, and at the effect of antibiotic usage on the spread of MRSA in these settings. Finally, we summarize recommendations for the prevention and control of MRSA, which can be applied to the Latin American hospital environment and community setting.

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“…This is true for both HA-MRSA and CA-MRSA. Conditions such as overcrowding and understaffing in hospitals can contribute to high colonization pressure and increase the transmission risk (Clements, A. et al, 2008;Merrer, J. et al, 2000). MRSA control programmes and the application of strict hygiene measures can help to reduce transmission (Ben-David, D. et al, 2008;Eveillard, M. et al, 2006).…”

Section: Vectors For Transmission Of Mrsamentioning

confidence: 99%

Untitled

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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Overcrowding and understaffing in modern health-care systems: key determinants in meticillin-resistant Staphylococcus aureus transmission

Cited by 189 publications

References 130 publications

Re-thinking microbiology/infection control education to enhance the practice-readiness of health professional students: More than just a curriculum issue

Re-thinking microbiology/infection control education to enhance the practice-readiness of health professional students: More than just a curriculum issue

Prevention strategies for methicillin-resistant Staphylococcus aureus (MRSA) in Latin America

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