Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T09:59:22.170Z Has data issue: false hasContentIssue false

Methicillin-Resistant Staphylococcus aureus in Geriatric Patients: Usefulness of Screening in a Chronic-Care Setting

Published online by Cambridge University Press:  02 January 2015

Daniel R. Talon*
Affiliation:
Service d'Hygiène Hospitalière, CHU Besançon, France
Xavier Bertrand
Affiliation:
Service d'Hygiène Hospitalière, CHU Besançon, France
*
Service d'Hygiène Hospitaliere, Bd Fleming, 25030 Besançon Cedex, France

Abstract

Objective:

To evaluate the contribution of screening to the detection of cases of methicillin-resistant Staphylococcus aureus (MRSA) in a chronic-care facility.

Design:

Surveillance and laboratory observational study.

Methods:

During a 7-month period, we compared imported and acquired MRSA in a chronic-care center by screening patients for carriage of MRSA on admission and discharge, and by recording all cases of clinical specimens positive for MRSA

Setting:

The study was conducted in a 120-bed chronic-care center. This center admits approximately 850 patients per year. Approximately 90% of the patients were elderly and were admitted from other hospitals.

Results:

Of 519 patients admitted during the study period, 129 were positive for MRSA at some point during their residence, including 60 (11.6%) with MRSA found within 48 hours of admission and 69 (13.3%; 53% of all positives) with nosocomial MRSA Of the 519 admissions, 332 (64%) were discharged, of whom 62 (19%) were positive for MRSA. Of these 62, 43 (69%) acquired their MRSA during their stay in the center.

Conclusions:

Our study confirms the amplification effect of chronic-care facilities on MRSA propagation. It also shows that screening for MRSA carriage in a chronic-care center facilitates the early identification of a large proportion of patients with MRSA.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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. Observatoire National de l'Epidémiologie de la Résistance Bactérienne aux Antibiotiques (ONERBA). Staphylococcus aureus résistant à la méti-cilline (MRSA) vus de l’hópital en 1997. Rapport technique de synthèse pour l'année 1997, Résultats. Paris, France: ONERBA; 1998:2634.Google Scholar
2. Cailleaux, V, Talon, D, Thouverez, M, Bailly, P, Mulin, B, Michel-Briand, Y. Staphylococcus aureus méticillino-résistant: importance et transmission croisée dans l’est de la France. Med Mai Infect 1996;79:475481.CrossRefGoogle Scholar
3. Réseau des laboratoires du C.CLIN Sud-Ouest. Enquête multicentrique 1995. Résistance à la méticilline des Staphylococcus aureus dans les hôpitaux du Sud-Ouest de la France. BEH 1995;13:5859.Google Scholar
4. Talon, D, Cailleaux, V, Gayet, S, Thouverez, M, Aby, MA, Bientz, M. Multicenter study of hospital epidemiology of methicillin-resistant Staphylococcus aureus in eastern France. Eur J Intern Med 1996;7:153158.Google Scholar
5. Kerr, S, Kerr, GE, Mackintosh, CA, Marples, RR. A survey of methicillin-resistant Staphylococcus aureus affecting patients in England and Wales. J Hosp Infect 1990;16:3548.Google Scholar
6. Cookson, BD. Methicillin-resistant Staphylococcus aureus in the community: new battlefronts, or are the battles lost? Infect Control Hosp Epidemiol 2000;21:398403.Google Scholar
7. Cookson, BD. Nosocomial antimicrobial resistance surveillance. J Hosp Infect 1999;43(suppl):S97S103.CrossRefGoogle ScholarPubMed
8. Mulligan, ME, Murray-Leisure, KA, Ribner, BS, John, JF, Korvick, JA, Kauffman, CA, et al. Methicillin-resistant Staphylococcus aureus: a consensus review of the microbiology, pathogenesis, and epidemiology with implications for prevention and management. Am J Med 1993;94:313328.Google Scholar
9. Hospital Infection Society and British Society for Antimicrobial Chemotherapy. Revised guidelines for the control of epidemic methicillin-resistant Staphylococcus aureus . J Hosp Infect 1990;16:351377.CrossRefGoogle Scholar
10. Boyce, JM. Methicillin-resistant Staphylococcus aureus: a continuing infection control challenge. Eur J Clin Microbiol Infect Dis 1994;13:4549.Google Scholar
11. Walsh, TJ, Vlahof, D, Hansen, SL, Sonnenberg, E, Khabbaz, R, Gadacz, T, et al. Prospective microbiologic surveillance in control of nosocomial methicillin-resistant Staphylococcus aureus . Infect Control 1987;8:777814.CrossRefGoogle ScholarPubMed
12. Boyce, JM, Jackson, MM, Pugliese, G, Batt, MD, Fleming, D, Garner, JS, et al. Methicillin-resistant Staphylococcus aureus (MRSA): a briefing for acute care hospitals and nursing facilities. The AHA Technical Panel on Infections Within Hospitals. Infect Control Hosp Epidemiol 1994;15:105115.Google Scholar
13. 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 high level of endemic MRSA. Clin Infect Dis 1998;27:543550.Google Scholar
14. Talon, D, Rouget, C, Cailleaux, V, Bailly, P, Thouverez, M, Barale, F, et al. Nasal carriage of Staphylococcus aureus and cross-contamination in a surgical intensive-care unit efficacy of mupirocin ointment. JHosp Infect 1995;30:3949.Google Scholar
15. Chaix, C, Durand-Zaleski, I, Alberti, C, Brun-Buisson, C. Control of endemic methicillin-resistant Staphylococcus aureus: a cost-benefit analysis in an intensive care unit. JAMA 1999;282:17451751.Google Scholar
16. Comité de l'Antibiogramme de la Société Française de Microbiologie. Communiqué 1996. Pathol Biol 1996;44:18.Google Scholar
17. Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128140.Google Scholar
18. Pujol, M, Pena, C, Pallares, R, Ariza, J, Ayats, J, Dominguez, MA, et al. Nosocomial Staphylococcus aureus bacteremia among nasal carriers of methicillin-resistant and methicillin-susceptible strains. Am J Med 1996;100:509516.Google Scholar
19. Lucet, JC, Chevret, S, Decré, D, Vanjak, D, Macrez, A, Bédos, JP, et al. Outbreak of multiple-resistant Enterobacteriaceae in an intensive-care unit: epidemiology and risk factors for acquisition. Clin Infect Dis 1996;22:430436.CrossRefGoogle Scholar
20. De Champs, C, Rouby, D, Guelon, D, Sirot, J, Beytout, D, Gourgand, JM. A case-control study of an outbreak of infections caused by Klebsiella pneumoniae strains producing CTX-1 (TEM-3) β-lactamase. J Hosp Infect 1991;18:513.CrossRefGoogle ScholarPubMed
21. Scerpella, EG, Wanger, AR, Armitige, L, Anderlini, P, Ericsson, CD. Nosocomial outbreak caused by a multiresistant clone of Acinetobacter baumannii: results of the case-control and molecular epidemiology investigations. Infect Control Hosp Epidemiol 1995;16:9297.CrossRefGoogle Scholar
22. Crossley, K, Loesch, D, Landesman, B, Mead, K, Chern, M, Strate, R. An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. J Infect Dis 1979;139:273287.Google Scholar
23. Casewell, MW, Hill, RLR. The carrier state: methicillin-resistant Staphylococcus aureus . J Antimicrob Chemother 1986;18(suppl A):112.Google Scholar