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Epidemiology of Methicillin-Resistant Staphylococcus aureus in Three Canadian Tertiary-Care Centers

Published online by Cambridge University Press:  02 January 2015

Kathryn Suh ,
Baldwin Toye ,
Peter Jessamine ,
Francis Chan  and
Karam Ramotar
Kathryn Suh
Affiliation:
Ottawa General Hospital, Ottawa, Ontario, Canada University of Ottawa, Ottawa, Ontario, Canada
Baldwin Toye
Affiliation:
Ottawa General Hospital, Ottawa, Ontario, Canada University of Ottawa, Ottawa, Ontario, Canada
Peter Jessamine
Affiliation:
Ottawa Civic Hospital, Ottawa, Ontario, Canada University of Ottawa, Ottawa, Ontario, Canada
Francis Chan
Affiliation:
Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada University of Ottawa, Ottawa, Ontario, Canada
Karam Ramotar*
Affiliation:
Ottawa General Hospital, Ottawa, Ontario, Canada University of Ottawa, Ottawa, Ontario, Canada
*
Division of Microbiology, Ottawa General Hospital, 501 Smyth Rd, Ottawa, Ontario K1H 8L6, Canada
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Abstract

OBJECTIVE:

To describe the epidemiology and spread of methicillin-resistant Staphylococcus aureus (MRSA) in three tertiary-care centers in Ottawa, Ontario, Canada, where MRSA is encountered infrequently.

DESIGN:

Retrospective review over a 6-year period, from January 1, 1990, through December 31, 1995.

SETTING:

Three tertiary-care teaching hospitals in Ottawa.

PARTICIPANTS:

Patients and healthcare workers (HCWs) with MRSA isolated from any body site.

METHODS:

Patients and HCWs were identified retrospectively through hospital microbiology and infection control records. Patient charts were reviewed for clinical and epidemiological data, including age, gender, previous hospital admissions (where noted), and current and recent antibiotic use. MRSA isolates that were available were typed using pulsed-field gel electrophoresis (PFGE). Methicillin resistance was confirmed by standard methods and by polymerase chain reaction using mecA-specific primers.

RESULTS:

MRSA was identified in 53 patients and 2 HCWs. Three patients were excluded from further analysis because medical records were incomplete. Epidemiological data were collected on the remaining 52 individuals. Thirty-nine isolates from 31 patients and 2 HCWs were available for PFGE typing. Five epidemiologically linked nosocomial clusters involving 10 patients and 2 HCWs were identified and were confirmed by PFGE. MRSA isolates from a sixth cluster were not available for PFGE. In each cluster, nosocomial spread was minimized by standard infection control practices, including strict isolation of patients and screening of contacts. There was no evidence of secondary spread of MRSA involving the remaining 36 patients. Recent antibiotic use, surgery, admission to an intensive-care unit, and previous hospitalization were common among patients. There was no evidence of spread of MRSA among the three hospitals, and no endemic strains were apparent in any of these centers.

CONCLUSIONS:

MRSA remains an infrequent isolate in our centers, with no apparent interhospital spread. In institutions with little or no endemic MRSA, rigorous application of standard infection control practices is effective in limiting nosocomial transmission of this organism.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 6 , June 1998 , pp. 395 - 400
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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