[Scientific article] The dissemination of staph infections in hospitals

From the ScienceDaily summary

Date:March 19, 2015
Source:PLOS
Summary:Wireless sensors recording human interactions explain the transmission of germs, such as MRSA, in hospitals, according to new research.

…

The results indicate that the study of individuals contact may help identify increased risk of transmission situations and ultimately reduce the burden of nosocomial S. aureus transmission.

The researchers say: “Contact networks have been increasingly used in modeling the spread of infectious diseases. Yet, the contacts collected were often incomplete or used proxies that were thought to capture situation at risk. In this unique experiment, the joint analysis of contact and carriage validates the use of close-proximity interactions recorded by electronic devices, and opens a new field for prevention measures in hospitals.”

…

[News release] MRSA can linger in homes, spreading among its inhabitants

View image | gettyimages.com

From the 10 March 2015 EurkAlert!

Households can serve as a reservoir for transmitting methicillin-resistant Staphylococcus aureus (MRSA), according to a study published this week inmBio®, the online open-access journal of the American Society for Microbiology. Once the bacteria enters a home, it can linger for years, spreading from person to person and evolving genetically to become unique to that household.

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The researchers found that isolates within households clustered into closely related groups, suggesting a single common USA300 ancestral strain was introduced to and transmitted within each household. Researchers also determined from a technique called Bayesian evolutionary reconstruction that USA300 MRSA persisted within households from 2.3 to 8.3 years before their samples were collected, and that in the course of a year, USA300 strains had a 1 in a million chance of having a random genetic change, estimating the speed of evolution in these strains. Researchers also found evidence that USA300 clones, when persisting in households, continued to acquire extraneous DNA.

“We found that USA300 MRSA strains within households were more similar to each other than those from different households,”

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We’re also getting hints at how it evolves inside households. Decolonization of household members may be a critical component of prevention programs to control USA300 MRSA spread in the United States.”

Related Article

Highly effective regimen for decolonization of methicillin-resistant Staphylococcus aureus carriers.“Standardized decolonization treatment consisted of mupirocin nasal ointment, chlorhexidine mouth rinse, and full-body wash with chlorhexidine soap for 5 days. Intestinal and urinary-tract colonization were treated with oral vancomycin and cotrimoxazole, respectively. Vaginal colonization was treated with povidone-iodine or, alternatively, with chlorhexidine ovula or octenidine solution. Other antibiotics were added to the regimen if treatment failed.”

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Antibacterial Drugs and the Risk of Community-Associated Methicillin-Resistant Staphylococcus aureus in Children

Proportion of MRSA human blood isolates from participating countries in 2008***

From the 14 December edition of Full Text Reports

Antibacterial Drugs and the Risk of Community-Associated Methicillin-Resistant Staphylococcus aureus in Children

Source:  Archives of Pediatrics & Adolescent Medicine

Objective
To investigate in children the association between antibacterial drugs and subsequent diagnosis of methicillin-resistant Staphylococcus aureus (MRSA) in the community.

Design
Population-based case-control study in children 1 to 19 years of age.

Setting
Primary care, General Practice Research Database, United Kingdom, 1994-2007.

Participants
Cases were children who had MRSA diagnosed as outpatients, and controls were individually matched on age and practice, with the matched case’s diagnosis date as the index date for both.

Main Exposures
Antibacterial agents prescribed 180 to 30 days prior to the index date, excluding prescriptions 30 days before the index date to prevent protopathic bias.

Outcome Measures
Rate ratios (RRs) estimated from the odds ratios of exposure in cases compared with controls using conditional logistic regression, adjusted for comorbid conditions, other prescription drug use, and hospitalization.

Results
The rate of MRSA was 4.5 per 100 000 per year. Of 297 cases and 9357 controls, 52.5% and 13.6%, respectively, received antibacterial drug prescriptions during the 150-day exposure window. The adjusted RR with any antibacterial drug was 3.5 (95% confidence interval [CI], 2.6-4.8). The RRs increased with the number of prescriptions (2.2 [95% CI, 1.5-3.2], 3.3 [95% CI, 1.9-5.6], 11.0 [95% CI, 5.6-21.6], and 18.2 [95% CI, 9.4-35.4] for 1, 2, 3, and 4 prescriptions, respectively). The RR was particularly elevated for quinolones at 14.8 (95% CI, 3.9-55.8), with wide variation among antibacterial classes.

Conclusion
While close to half of children were diagnosed as having MRSA in the community without prior antibacterial drugs, such agents are associated with a dose-dependent increased risk, concordant with findings in adults.

***Image from http://commons.wikimedia.org/wiki/File:EARSS_MRSA_2008.sv, Institute for Public Health and the Environment (RIVM), Epidemiology and Surveillance, 3720 BA Bilthoven,The Netherlands

 

Related Resources

• MRSA (MedlinePlus) A general guide with links to overviews, diagnosis/symptoms, specific conditions, news items, and more
• MRSA Infection (eMedicine Health)  A patient/consumer guide with links to diagnosis/symptoms, risk factors, images, and slideshows
• Methicillin-resistant Staphylococcus Aureus (MRSA) Infections (CDC) Comprehensive guide with links to definition, symptoms, prevention, people at risk, environmental cleaning, statistics, and educational resources

   

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