Prevalence of Colonization and Infection with Methicillin-ResistantStaphylococcus aureusand Vancomycin-ResistantEnterococcusand ofClostridium difficileInfection in Canadian Hospitals

Simor, Andrew E.; Williams, Victoria; McGeer, Allison; Raboud, Janet; Larios, Oscar; Weiss, Karl Heinz; Hirji, Zahir; Laing, Felicia; Moore, Christine; Gravel, Denise

doi:10.1086/670998

Cited by 37 publications

(25 citation statements)

References 34 publications

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“…The observation that all MRSA isolates were susceptible to linezolid is similar to reports from other countries that MRSA isolates were susceptible to linezolid [20,22,25] . In addition, the MIC distribution of the glycopeptide antibiotics showed that the majority ( ∼ 97%) of the isolates were susceptible to vancomycin and teicoplanin (MIC: ≤ 2 μg/ml), confirming that vancomycin and teicoplanin remain viable options for treating MRSA infections in Kuwait.…”

Section: Discussionsupporting

confidence: 88%

“…The majority (40.9%) of the isolates in this study originated from skin and soft tissue infections concurring with the findings of a previously published study [22] . The results also mimicked the findings of a surveillance study conducted in 2005 in Kuwait hospitals [23] and two studies conducted in the USA and Canada [20,24] where skin and soft tissues were the major sources of MRSA isolates. In contrast to the findings of this study, lower respiratory tract samples were the major sources accounting for 40.6% of MRSA isolates obtained during an Italian national survey conducted in 2012 [25] .…”

Section: Discussionsupporting

confidence: 79%

“…This is of concern because MRSA limits the choices of antibiotics available for treating infections caused by them, often warranting the use of more expensive antibiotics [20,21] . The majority (40.9%) of the isolates in this study originated from skin and soft tissue infections concurring with the findings of a previously published study [22] .…”

Section: Discussionmentioning

confidence: 99%

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Antibiotic Resistance Trends in Methicillin-Resistant Staphylococcus aureus Isolated in Kuwait Hospitals: 2011-2015

Udo

Boswihi²

2017

Med Princ Pract

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Objective: The aim of this study was to determine antibiotic resistance trends and carriage of staphylococcal cassette chromosome mec (SCCmec) genetic elements in methicillin-resistant Staphylococcus aureus (MRSA) isolated in Kuwait hospitals to ascertain whether they were healthcare associated (HA-MRSA) or community associated (CA-MRSA). Materials and Methods: In total, 6,922 MRSA isolates obtained from different clinical samples were tested for resistance toantibiotics, urease production, and carriage of SCCmec elements. Results: All MRSA isolates were susceptible to linezolid, vancomycin, and teicoplanin. However, some isolates were resistant to kanamycin (2,979; 43%), ciprofloxacin (2,955; 42.7%), erythromycin and clindamycin (2,935; 42.4%), fusidic acid (2,858; 41.2%), gentamicin (2,665; 38.5%), tetracycline (2,652; 38.3%), and trimethoprim (2,324; 33.5%). Whereas the prevalence of resistance to most antibiotics showed annual variations, those resistant to chloramphenicol and rifampicin increased from 2.6 and 0.1% to 9.6 and 1.6%, respectively, and high-level mupirocin resistance declined from 9.3% in 2011 to 3.6% in 2015. In total, 3,244 (53.9%) of the isolates carried SCCmec IV followed by SCCmec III (1,737; 28.8%) and SCCmec V (890; 14.8%). SCCmec I (21; 0.3%) and II (79; 0.8%) occurred sporadically. A total of 3,651 (60.7%) of the isolates belonged to the CA-MRSA genotype and 2,290 isolates (38.1%) were identified as HA-MRSA. Conclusion: This study demonstrates changes in antibiotic resistance patterns of MRSA over time and reinforces the value of surveillance in detecting such changes for the benefit of infection control and patient management.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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Antibiotic Resistance Trends in Methicillin-Resistant Staphylococcus aureus Isolated in Kuwait Hospitals: 2011-2015

Udo

Boswihi²

2017

Med Princ Pract

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“…The method used for the detection of C difficile is a major factor in the detection of CDI, and in the declaration and end of outbreaks. Improved diagnostic methods and a robust antibiotic stewardship program, 6 in addition to infection control policies and practices, environmental cleaning, 7 improving hand hygiene practices, 8 hospital design, 9 and better identification of asymptomatic carriers 10 should all result in better control of CDI.…”

Section: Discussionmentioning

confidence: 99%

Impact of polymerase chain reaction testing on Clostridium difficile infection rates in an acute health care facility

Murad

Perez²,

Nokhbeh

et al. 2015

American Journal of Infection Control

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Two rapid methods of Clostridium difficile infection (CDI) diagnosis were compared between June 2012 and March 2013: a GeneXpert (Cepheid, Sunnyvale, Calif) polymerase chain reaction (PCR) test and an enzyme immunoassay (EIA). The influence of these methods on the detection of hospital-acquired CDI and identification of CDI outbreaks was evaluated. We tested 1,592 stool samples for C difficile. The GeneXpert PCR test identified 211 positive samples (68 determined to be hospital-acquired infection), whereas EIA identified 105 positive samples (36 determined to be hospital-acquired infection). The GeneXpert PCR method in contrast to the EIA method increased the detection rates of nosocomial CDI cases and contributed to the declaration of CDI outbreaks.

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“…Although providing important incidence data, the surveillance is limited in that only a relatively small number of hospitals, predominantly tertiary-care teaching facilities participate. In 2010 we conducted the first national prevalence survey of AROs, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycinresistant Enterococcus (VRE), and Clostridium difficile infection (CDI), in a large and representative sample of Canadian hospitals [5]. However, as the epidemiology of these organisms continues to evolve it is important to monitor changes that may occur over time.…”

Section: Introductionmentioning

confidence: 99%

Is the prevalence of antibiotic-resistant organisms changing in Canadian hospitals? Comparison of point-prevalence survey results in 2010 and 2012

Williams

Simor

Kiss

et al. 2015

Clinical Microbiology and Infection

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A national point-prevalence survey for infection or colonization with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE), and for Clostridium difficile infection (CDI) was done in Canadian hospitals in 2010. A follow-up survey was done in November 2012 to determine whether there were any changes in the prevalence of these organisms; we also determined the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CREs). Associations between prevalence and infection prevention and control policies were evaluated in logistic regression models. A total of 143 (67% of eligible facilities) hospitals with 29 042 adult inpatients participated in the survey, with representation from all 10 provinces; 132 hospitals participated in 2010 and 2012. There were no significant changes in the median prevalence of MRSA in 2010 (4.3%) compared to 2012 (3.9%), or of CDI in 2010 (0.8%) compared to 2012 (0.9%). A higher median prevalence of VRE was identified in 2012 (1.3%) compared to 2010 (0.5%) (p 0.04), despite decreased VRE screening in 2012. The median prevalence of ESBLs was 0.7% and was 0 for CREs; CREs were reported from only 10 hospitals (7.0%). A policy of routinely caring for patients with MRSA or VRE in a private isolation room was associated with lower prevalence of these organisms. Targeted screening of high-risk patients at admission was associated with lower MRSA prevalence; better hand hygiene compliance was associated with lower VRE prevalence. These data provide national prevalence rates for antibiotic-resistant organisms among adults hospitalized in Canadian hospitals. Certain infection prevention and control policies were associated with prevalence.

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Prevalence of Colonization and Infection with Methicillin-ResistantStaphylococcus aureusand Vancomycin-ResistantEnterococcusand ofClostridium difficileInfection in Canadian Hospitals

Abstract: These data provide the first national prevalence estimates for MRSA, VRE, and CDI in Canadian hospitals. Certain infection prevention and control policies were found to be associated with prevalence and deserve further investigation.

Cited by 37 publications

References 34 publications

Antibiotic Resistance Trends in Methicillin-Resistant Staphylococcus aureus Isolated in Kuwait Hospitals: 2011-2015

Antibiotic Resistance Trends in Methicillin-Resistant Staphylococcus aureus Isolated in Kuwait Hospitals: 2011-2015

Impact of polymerase chain reaction testing on Clostridium difficile infection rates in an acute health care facility

Is the prevalence of antibiotic-resistant organisms changing in Canadian hospitals? Comparison of point-prevalence survey results in 2010 and 2012

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