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Carriage of Methicillin-Resistant Staphylococcus aureus Among Hospital Employees: Prevalence, Duration, and Transmission to Households

Published online by Cambridge University Press:  02 January 2015

Matthieu Eveillard ,
Yolaine Martin ,
Nadia Hidri ,
Yves Boussougant  and
Marie-Laure Joly-Guillou
Matthieu Eveillard*
Affiliation:
Service de Microbiologie et d'Hygiène, Hôpital Louis-Mourier, Assistance Publique-Hôpitaux de Paris, France, Colombes, France
Yolaine Martin
Affiliation:
Service de Microbiologie et d'Hygiène, Hôpital Louis-Mourier, Assistance Publique-Hôpitaux de Paris, France, Colombes, France
Nadia Hidri
Affiliation:
Service de Microbiologie et d'Hygiène, Hôpital Louis-Mourier, Assistance Publique-Hôpitaux de Paris, France, Colombes, France
Yves Boussougant
Affiliation:
Service de Microbiologie et d'Hygiène, Hôpital Louis-Mourier, Assistance Publique-Hôpitaux de Paris, France, Colombes, France
Marie-Laure Joly-Guillou
Affiliation:
Service de Microbiologie et d'Hygiène, Hôpital Louis-Mourier, Assistance Publique-Hôpitaux de Paris, France, Colombes, France
*
Service de Microbiologie et d'Hygiène, Hôpital Louis-Mourier, 178 rue des Renouillers, F 92700 Colombes Cedex, France
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Abstract

Objective:

To assess the prevalence and duration of methicillin-resistant Staphylococcus aureus (MRSA) carriage among hospital employees and transmission to their households.

Design:

A point-prevalence survey of MRSA carriage (nasal swabbing) of staff and patients throughout the hospital; a prevalence survey of MRSA carriage in 2 medical wards, with carriers observed to estimate carriage duration; and evaluation of transmission to MRSA-positive workers' families. All MRSA isolates were analyzed by pulsed-field gel electrophoresis. During the study, no MRSA outbreak was detected among hospitalized patients.

Setting:

A 600-bed, public tertiary-care teaching hospital near Paris.

Results:

Sixty MRSA carriers were identified among 965 healthcare providers (prevalence, 6.2%; CL,, 4.7%-7.7%). Prevalence was higher in staff from clinical wards than from elsewhere (9.0% vs 2.1%; P < .0001). Identity of isolates from employees and patients varied from 25% in medical wards to 100% in the long-term-care facility. MRSA carriage was identified in 14 employees from 2 medical wards (prevalence, 19.4%; CI95, 10.3%-28.5%). Prevalence depended on the length of service in these wards. Transmission to households was investigated in 10 MRSA-positive workers' families and was found in 4. All isolates from each family were identical.

Conclusions:

Few data are available concerning the prevalence of MRSA carriers among hospital employees in the absence of an outbreak among patients. MRSA transmission between patients and employees likely depends on the frequency and duration of exposure to MRSA-positive patients and infection control measures employed. Frequent transmission of MRSA from colonized healthcare workers to their households was documented.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 2 , February 2004 , pp. 114 - 120
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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References

1.Barrett, FF, McGehee, RF, Finland, M. Methicillin-resistant Staphylococcus aureus at Boston City Hospital'. bacteriologie and epidemiologic observations. N Engl J Med 1968;279:441–448.CrossRefGoogle Scholar
2.Lepelletier, D, Richet, H. Surveillance and control of methicillin-resistant Staphylococcus aureus infections in French hospitals. Infect Control Hosp Epidemiol 2001;22:677–682.CrossRefGoogle ScholarPubMed
3.Muder, RR, Brennen, C, Goetz, AM. Infection with methicillin-resistant Staphylococcus aureus among hospital employees. Infect Control Hosp Epidemiol 1993;14:576–578.CrossRefGoogle ScholarPubMed
4.Lessing, MP, Jordens, JZ, Bowler, IC. When should healthcare workers be screened for methicillin-resistant Staphylococcus aureus? J Hosp Infect 1996;34:205–210.CrossRefGoogle ScholarPubMed
5.Mitsuda, T, Arai, K, Ibe, M, Imagawa, T, Tomono, N, Yokota, S. The influence of methicillin-resistant Staphylococcus aureus (MRSA) carriers in a nursery and transmission of MRSA to their households. J Hosp Infect 1999;42:45–51.CrossRefGoogle Scholar
6.Allen, KD, Anson, JJ, Parsons, LA, Frost, NG. Staff carriage of methicillin-resistant Staphylococcus aureus (EMRSA 15) and the home environment: a case report. J Hosp Infect 1997;35:307–311.CrossRefGoogle ScholarPubMed
7.Wagenvoort, JH, Toenbrecker, HM, Nurmohamed, A, Davies, BI. Transmission of methicillin-resistant Staphylococcus aureus within a household. Eur J Clin Microbiol Infect Dis 1997;16:399–400.CrossRefGoogle ScholarPubMed
8.Comité de l'Antibiogramme de la Société Française de Microbiologie. Communiqué 1999. Pathol Biol 1999;47:845–872.Google Scholar
9.Goering, RV, Duensing, TD. Rapid field inversion gel electrophoresis in combination with an rRNA gene probe in the epidemiological evaluation of staphylococci. J Clin Microbiol 1990;28:426–429.Google Scholar
10.Maslow, JN, Slutsky, A, Arbeit, RD. The application of pulsed-field gel electrophoresis to molecular epidemiology. In: Persing, DH, Smith, TE, Tenover, FC, White, TJ, eds. Diagnostic Molecular Microbiology: Principles and Applications. Washington, DC: American Society for Microbiology; 1993:563–572.Google Scholar
11.Tenover, FC, Arbeit, RD, Goering, RV, et al.Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:2233–2239.CrossRefGoogle ScholarPubMed
12.Coello, R, Jimenez, J, Garcia, M, et al.Prospective study of infection, colonization and carriage of methicillin-resistant Staphylococcus aureus in an outbreak affecting 990 patients. EurJ Clin Microbiol Infect Dis 1994;13:74–81.CrossRefGoogle Scholar
13.Sanford, MD, Widmer, AF, Baie, MJ, Jones, RN, Wenzel, RP. Efficient detection and long-term persistence of the carriage of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 1994;19:1123–1128.CrossRefGoogle ScholarPubMed
14.Girou, E, Pujade, G, Legrand, P, Cizeau, F, Brun-Buisson, C. Selective screening of carriers for control of methicillin-resistant Staphylococcus aureus (MRSA) in high-risk hospital areas with a high level of endemie MRSA. Clin Infect Dis 1998;27:543–550.CrossRefGoogle Scholar
15.Cox, RA, Conquest, C. Strategies for the management of healthcare staff colonized with epidemie methicillin-resistant Staphylococcus aureus. J Hosp Infect 1997;35:117–127.CrossRefGoogle Scholar
16.Duckworth, GJ, Lothian, JLE, Williams, JD. Methicillin-resistant Staphylococcus aureus: report of an outbreak in a London teaching hospital. J Hosp Infect 1988;11:1–15.CrossRefGoogle Scholar
17.King, K, Brady, L, Thomson, M, Harkness, JL. Antibiotic-resistant staphylococci in a teaching hospital. MedJAust 1982;2:461–465.Google ScholarPubMed
18.Richardson, JF, Quoraishi, AHM, Francis, BJ, Marples, RR. Beta-lactamase negative, methicillin-resistant Staphylococcus aureus in a new-born nursery: report of an outbreak and laboratory investigations. J Hosp Infect 1990;16:109–121.CrossRefGoogle Scholar
19.Abudu, L, Blair, I, Fraise, A, Cheng, KK. Methicillin-resistant Staphylococcus aureus (MRSA) : a community-based prevalence survey. Epidemiol Infect 2001;126:351–356.Google Scholar
20.Merrer, J, Santoli, F, Appere de Vecchi, C, Tran, B, De Jonghe, B, Outin, H. “Colonization pressure” and risk of acquisition of methicillin-resistant Staphylococcus aureus in a medical intensive care unit. Infect Contrat Hosp Epidemiol 2000;21:718–723.Google Scholar
21.Goetz, A, Posey, K, Fleming, J, et al.Methicillin-resistant Staphylococcus aureus in the community: a hospital-based study. Infect Control Hosp Epidemiol 1999;20:689–691.Google Scholar
22.Coello, R, Glynn, JR, Gaspar, C, Picazo, JJ, Fereres, J. Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA. J Hosp Infect 1997;37:39–46.CrossRefGoogle ScholarPubMed
23.Baran, J, Ramanathan, J, Riederer, KM, Khatib, R. Stool colonization with vancomycin-resistant enterococci in healthcare workers and their households. Infect Control Hosp Epidemiol 2002;23:23–26.CrossRefGoogle ScholarPubMed
24.Cefai, C, Ashurst, S, Owens, C. Human carriage of methicillin-resistant Staphylococcus aureus linked with pet dog. Lancet 1994;344:539–540.CrossRefGoogle ScholarPubMed
25.Masterson, RG, Coia, JE, Notman, AW, Kempton-Smith, L, Cookson, BD. Refractory methicillin-resistant Staphylococcus aureus carriage associated with contamination of the home environment. J Hosp Infect 1995;29:318–319.CrossRefGoogle Scholar
26.Rosenberg, J. Methicillin-resistant Staphylococcus aureus (MRSA) in the community: who's watching? Lancet 1995;346:132–133.Google Scholar
27.Moreno, F, Crisp, C, Jorgensen, JH, Patterson, JE. Methicillin-resistant Staphylococcus aureus as a community organism. Clin Infect Dis 1995;2:1308–1312.Google Scholar
28.Lindenmayer, JM, Schoenfeld, S, O'Grady, R, Caeney, JK. Methicillin-resistant Staphylococcus aureus in a high school wrestling team and the surrounding community. Arch Intern Med 1998;158:895–899.CrossRefGoogle Scholar
29.Akram, J, Glatt, AE. True community-acquired methicillin-resistant Staphylococcus aureus bacteremia. Infect Control Hosp Epidemiol 1998;19:106–107.CrossRefGoogle ScholarPubMed
30.Torvaldesen, S, Roberts, C, Riley, TV. The continuing evolution of methicillin-resistant Staphylococcus aureus in western Australia. Infect Control Hosp Epidemiol 1999;20:133–135.Google Scholar
31.Charlebois, ED, Bangsberg, DR, Moss, NJ, et al.Population-based community prevalence of methicillin-resistant Staphylococcus aureus in the urban poor of San Francisco. Clin Infect Dis 2002;34:425–433.Google Scholar
32.Cookson, BD. Methicillin-resistant Staphylococcus aureus in the community: new battlefronts or are the battles lost? Infect Control Hosp Epidemiol 2000;21:398–403.Google Scholar