Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-28T00:36:56.188Z Has data issue: false hasContentIssue false
  • English
  • Français

Control of Epidemic Methicillin-Resistant Staphylococcus aureus

Published online by Cambridge University Press:  21 June 2016

Katherine A. Murray-Leisure ,
Sandra Geib ,
Diane Graceley ,
Arline B. Rubin-Slutsky ,
Narendra Saxena ,
H. Arnold Muller  and
Bruce H. Hamory
Katherine A. Murray-Leisure*
Affiliation:
Lebanon Veterans' Administration Medical Center, Lebanon, Pennsylvania
Sandra Geib
Affiliation:
Lebanon Veterans' Administration Medical Center, Lebanon, Pennsylvania
Diane Graceley
Affiliation:
Lebanon Veterans' Administration Medical Center, Lebanon, Pennsylvania
Arline B. Rubin-Slutsky
Affiliation:
Lebanon Veterans' Administration Medical Center, Lebanon, Pennsylvania
Narendra Saxena
Affiliation:
Lebanon Veterans' Administration Medical Center, Lebanon, Pennsylvania
H. Arnold Muller
Affiliation:
Lebanon Veterans' Administration Medical Center, Lebanon, Pennsylvania
Bruce H. Hamory
Affiliation:
Pennsylvania State University School of Medicine, Hershey, Pennsylvania
*
Infectious Diseases Section, Department of Medicine (111), Lebanon Veterans' Administration Medical Center, Zeban, PA 17042
Get access Rights & Permissions [Opens in a new window]

Abstract

We controlled the spread of epidemic methicillin-resistant Staphylococcus aureus (MRSA) infection in an 884-bed veterans' facility by cohorting known active MRSA carriers and MRSA-infected patients on one nursing unit. Simultaneously, all previously-institutionalized transfers into the veterans' facility were screened with swab cultures for MRSA at the time of admission. All MRSA patients were maintained on contact (gown and glove) or strict isolation and treated aggressively with topical and enteral antibiotics with the assistance of the infectious disease consultant. The monthly incidence of new MRSA patients dropped from a maximum of 16 per month to three or less per month within six months of instituting these infection control measures. There were no further MRSA bacteremias after the establishment of the MRSA cohort in a single unit. Aggressive cohort management of known MRSA patients and screening of previously-institutionalized patients on admission for MRSA controlled epidemic MRSA in this large institution.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 11 , Issue 7 , July 1990 , pp. 343 - 350
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Colley, EW, McNicol, MW, Bracken, PM. Methicillm-resistant Staphylococci in a general hospital. Lancet. 1965;1:595–597.CrossRefGoogle ScholarPubMed
2. Sorrel, TC, Packham, DR, Shanker, S, et al. Vancomycin therapy for methicillin-resistant Staphylococcus aureus . Ann Intern Med. 1982;97:344–350.CrossRefGoogle Scholar
3. Cookson, BD, Philips, I. Epidemic methicillin-resistant Staphylococcus aureus . J Antimicrob Chemother. 1988;2lSC:57–65.CrossRefGoogle Scholar
4. Lane, WR. Methicillin resistance in Staphylococci. Med J Aust. 1962;49:962–965.CrossRefGoogle Scholar
5. Thompson, RL, Wenzel, RP. Editorial: international recognition of methicillin- resistant strains of Staphylococcus aureus . Ann Intern Med. 1982;97:925–926.CrossRefGoogle Scholar
6. Guiguet, M, Rekacewicz, C, Leclercq, B, et al. Effectiveness of simple measures to control an outbreak of nosocomial methicillin-resistant Staphylococcus aureus infections in an intensive care unit. Infect Control Hosp Epidemiol. 1990;11:23–26.CrossRefGoogle Scholar
7. 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
8. Crossley, K, Loesch, D, Landesman, B, et al. An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. I. Clinical studies. J Infect Dis. 1979;139:273–279.CrossRefGoogle ScholarPubMed
9. Boyce, JM, Landry, M, Deetz, TR, et al. Epidemiologie studies of an outbreak of nosocomial methicillin-resistant Staphylococcus aureus infections. Infect Control. 1981;2:110–116.CrossRefGoogle Scholar
10. Haley, RW, Hightower, AW, Khabbaz, RF, et al. The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals. Ann Intern Med 1982;97:297–308.CrossRefGoogle ScholarPubMed
11. Thompson, RL, Cabezudo, I, Wenzel, RP. Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus . Ann Intern Med. 1982;97:309–317.CrossRefGoogle ScholarPubMed
12. Hall, LE, Klein, EG, Slater, LN, et al. A descriptive analysis of methicillin-resistant Staphylococcus aureus in veterans. Am J lnfect Control. 1988;16:89. Abstract.Google Scholar
13. Levine, DP, Cusing, RD, Jui, J, et al. Community-acquired methicillin-resistant Staphylococcus aureus endocarditis in the Detroit Medical Center. Ann Intern Med. 1982;97:330–338.CrossRefGoogle ScholarPubMed
14. Saravolatz, LD, Pohlod, DJ, Arking, LM. Community-acquired methicillin-resistant Staphylococcus aureus infections: a new source for nosocomial outbreaks. Ann Intern Med. 1982;97:325–329.CrossRefGoogle ScholarPubMed
15. Storch, GA, Radcliff, JL, Meyer, PL, et al. Methicillin-resistant Staphylococcus aureus in a nursing home. Infect Control. 1987;8:24–29.CrossRefGoogle ScholarPubMed
16. Cederna, JE, Terpenning, MS, Ensberg, M, et al. Staphylococcus aureus nasal colonization in a nursing home: eradication with mupirocin. Infect Control Hasp Epidemiol. 1990;11:13–16.CrossRefGoogle Scholar
17. McGowan, JE. Gram-positive bacteria: spread and antimicrobial resistance in university and community hospitals in the USA. J Antimicrob Agents Chemother. 1988;21SC:49–55.CrossRefGoogle Scholar
18. Rao, N, Jacobs, S, Joyce, L. Cost-effective eradication of an outbreak of methicillin-resistant Staphylococcus aureus in a community teaching hospital. Infect Control Hasp Epidemiol. 1988;9:255–260.CrossRefGoogle Scholar
19. Mylotte, JM, McDermott, D, Spooner, JA. Prospective study of 114 consecutive episodes of Staphylococcus aureus bacteremia. Rev Infect Dis. 1987:9:891–907.CrossRefGoogle ScholarPubMed
20. Locksley, RM, Cohen, ML, Qumn, TC, et al. Multiply antibiotic-resistant Staphylococcus aureus: introduction, transmission, and evolution of nosocomial infection. Ann Intern Med. 1982;97:317–324.CrossRefGoogle ScholarPubMed
21. Aldridge, KE. Methicillin-resistant Staphylococcus: clinical and laboratory features. Infect Control. 1985;6:461–465.CrossRefGoogle ScholarPubMed
22. Kristinsson, KG, Fenton, P, Norman, P. Control of epidemic methicillin-resistant Staphylococcus aureus . Lancet 1987;1:274–275.10.1016/S0140-6736(87)90093-6CrossRefGoogle ScholarPubMed
23. Roccaforte, JS, Bittner, MJ, Stumpt, CA, et al. Attempts to eradicate methicillin-resistant Staphylococcus aureus colonization with the use of trimethoprim-sulfamethoxazole, rifampin, and bacitracin. Am J Infect Control. 1988;16:141–146.CrossRefGoogle ScholarPubMed
24. Tufnell, D, Croton, RS, Hemingway, DM, et al. Methicillin-resistant Staphylococcus aureus; the role of antisepsis in the control of an outbreak. J Hosp Infect. 1987;10:255–259.CrossRefGoogle Scholar
25. Walsh, TJ, Vlahov, D, Hansen, SL, et al. Prospective microbiologic surveillance in control of nosocomial methicillin-resistant Staphylo-coccus aureus . Infect Control. 1987;8:7–14.CrossRefGoogle Scholar
26. Thornsberry, C, McDougal, LK. Successful use of broth microdilution in susceptibility tests for methicillin-resistant (heteroresistant) Staphylococci. J Clin Microbial. 1983;18:1084–1091.CrossRefGoogle ScholarPubMed
27. Brumfitt, W, Hamilton-Miller, J. Methicillin-resistant Staphylococcus aureus. N Engl J Med. 1989;320:1188–1196.CrossRefGoogle ScholarPubMed
28. Chambers, HF. Methicillin-resistant Staphylococci. Clin Microbial Rev. 1988;1:173–186.CrossRefGoogle ScholarPubMed
29. Longfield, JN, Townsend, TR, Cruess, DF, et al. Methicillin-resistant Staphylococcus aureus (MRSA): risk and outcome of colonized vs infected patients. Infect Control. 1985;6:445–450.CrossRefGoogle ScholarPubMed
30. Ribner, BS, Landry, MN, Gholson, GL. Strict versus modified isolation for prevention of nosocomial transmission of methicillin-resistant Staphylococcus aureus . Infect Control. 1986;7:317–320.CrossRefGoogle ScholarPubMed
31. Lynch, P, Jackson, MM, Cummings, MJ, et al. Rethinking the role of isolation practices in the prevention of nosocomial infections. Ann Intern Med. 1987;107:243–246.CrossRefGoogle ScholarPubMed
32. Zinner, SH, Lagast, H, Klastersky, J. Antistaphylococcal activity of rifampin and other antibiotics. J Infect Dis, 1981;144:365–371.CrossRefGoogle ScholarPubMed
33. Watanakunakorn, C. Treatment of infections due to methicillin-resistant Staphylococcus aureus . Ann Intern Med. 1982;97:376–378.CrossRefGoogle ScholarPubMed
34. Kerr, HD, Byrd, JC. Community hospital transfers to a VA Medical Center. JAMA. 1989;262:70–73.CrossRefGoogle ScholarPubMed
35. Bartzokas, CA, Paton, JH, Gibson, MR, et al. Control and eradication of methicillin-resistant Staphylococcus aureus on a surgical unit. N Engl J Med. 1984;311:1422–1425.CrossRefGoogle ScholarPubMed
36. Hartman, B, Tomasz, A. Altered penicillin-binding proteins in methicillin-resistant strains of Staphylococcus aureus . Antimicrob Agents Chemother. 1981;19:726–735.CrossRefGoogle ScholarPubMed
37. Sabath, LD. Mechanisms of resistance to b-lactam antibiotics in strains of Staphylococcus aureus . Ann Intern Med. 1982;97:339–344.CrossRefGoogle Scholar
38. Kayser, FH. Mechanisms of methicillin resistance in Staphylococci. Challenges in gram-positive infection. Microbiology Perspective. 1988;1:20–23.Google Scholar
39. Bitar, CM, Mayhall, CG, Lamb, VA, et al. Outbreak due to methicillm-and rifampin-resistant Staphylococcus aureus: epidemiology and eradication of the resistant strain from the hospital. Infect Control. 1987;8:15–23.CrossRefGoogle ScholarPubMed
40. Kristinsson, KG, Fenton, P, Norman, P. Control of epidemic methicillin-resistant Staphylococcus aureus . Lancet. 1987;1:274–275.CrossRefGoogle ScholarPubMed
41. Cookson, B, Talsania, H, Naidoo, J, et al. Strategies for typing and properties of epidemic methicillin-resistant Staphylococcus aureus . Eur J Clin Microbial Infect Dis. 1986;5:702–709.Google ScholarPubMed
42. Khalifa, IK, Heiban, AA, Hancock, G. Nontypeable bacteriophage patterns of methicillin-resistant Staphylococcus aureus involved in a hospital outbreak. J Clin Microbial. 1989;27:2249–2251.CrossRefGoogle Scholar
43. Mulligan, ME, Kwok, RYY, Citron, DM, et al. Immunoblots, antimicrobial resistance, and bacteriophage typing of oxacillin-resistant Staphylococcus aureus . J Clin Microbial. 1988;26:2395–2401.CrossRefGoogle ScholarPubMed