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Community- and Healthcare-Associated Methicillin-Resistant Staphylococcus aureus Strains: An Investigation Into Household Transmission, Risk Factors, and Environmental Contamination

Published online by Cambridge University Press:  08 November 2016

Wil Ng ,
Amna Faheem ,
Allison McGeer ,
Andrew E. Simor ,
Antonella Gelosia ,
Barbara M. Willey ,
Christine Watt ,
David C. Richardson ,
Henry Wong  and
Krystyna Ostrowska
...Show all authors
Wil Ng
Affiliation:
Infection Prevention and Control, North York General Hospital, Toronto, Canada
Amna Faheem
Affiliation:
Infection Prevention and Control, North York General Hospital, Toronto, Canada
Allison McGeer
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Canada University of Toronto, Toronto, Canada
Andrew E. Simor
Affiliation:
University of Toronto, Toronto, Canada Department of Microbiology, Sunnybrook Health Sciences Centre, Toronto, Canada
Antonella Gelosia
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Canada
Barbara M. Willey
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Canada
Christine Watt
Affiliation:
Department of Microbiology, Sunnybrook Health Sciences Centre, Toronto, Canada
David C. Richardson
Affiliation:
William Osler Health System, Brampton, Canada
Henry Wong
Affiliation:
Department of Microbiology, Sunnybrook Health Sciences Centre, Toronto, Canada
Krystyna Ostrowska
Affiliation:
Trillium Health Partners, Mississauga, Canada
Lee Vernich
Affiliation:
University of Toronto, Toronto, Canada
Matthew P. Muller
Affiliation:
University of Toronto, Toronto, Canada St. Michael’s Hospital, Toronto, Canada
Piraveina Gnanasuntharam
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Canada
Vanessa Porter
Affiliation:
Department of Microbiology, Mount Sinai Hospital, Toronto, Canada
Kevin Katz*
Affiliation:
Infection Prevention and Control, North York General Hospital, Toronto, Canada University of Toronto, Toronto, Canada
*
Address correspondence to Kevin Katz, MD, CM, MSc, FRCPC, Infection Prevention and Control, North York General Hospital, 4001 Leslie St, Toronto, Ontario, M2K 1E1 ([email protected]).
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Abstract

OBJECTIVE

To measure transmission frequencies and risk factors for household acquisition of community-associated and healthcare-associated (HA-) methicillin-resistant Staphylococcus aureus (MRSA).

DESIGN

Prospective cohort study from October 4, 2008, through December 3, 2012.

SETTING

Seven acute care hospitals in or near Toronto, Canada.

PARTICIPANTS

Total of 99 MRSA-colonized or MRSA-infected case patients and 183 household contacts.

METHODS

Baseline interviews were conducted, and surveillance cultures were collected monthly for 3 months from household members, pets, and 8 prespecified high-use environmental locations. Isolates underwent pulsed-field gel electrophoresis and staphylococcal cassette chromosome mec typing.

RESULTS

Overall, of 183 household contacts 89 (49%) were MRSA colonized, with 56 (31%) detected at baseline. MRSA transmission from index case to contacts negative at baseline occurred in 27 (40%) of 68 followed-up households. Strains were identical within households. The transmission risk for HA-MRSA was 39% compared with 40% (P=.95) for community-associated MRSA. HA-MRSA index cases were more likely to be older and not practice infection control measures (P=.002–.03). Household acquisition risk factors included requiring assistance and sharing bath towels (P=.001–.03). Environmental contamination was identified in 78 (79%) of 99 households and was more common in HA-MRSA households.

CONCLUSION

Household transmission of community-associated and HA-MRSA strains was common and the difference in transmission risk was not statistically significant.

Infect Control Hosp Epidemiol 2016;1–7

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 1 , January 2017 , pp. 61 - 67
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

Presented in part: IDWeek 2013; San Francisco, California; October 2-6, 2013 (Abstract 394).

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