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Nosocomial Transmission of Methicillin-Resistant Staphylococcus aureus: A Blinded Study to Establish Baseline Acquisition Rates

Published online by Cambridge University Press:  02 January 2015

Joel T. Fishbain ,
Joseph C. Lee ,
Honghung D. Nguyen ,
Jeffery A. Mikita ,
Cecilia P. Mikita ,
Catherine F. T. Uyehara  and
Duane R. Hospenthal
Joel T. Fishbain*
Affiliation:
Departments of Medicine and Clinical Investigation, Tripler Army Medical Center, Honolulu, Hawaii
Joseph C. Lee
Affiliation:
Departments of Medicine and Clinical Investigation, Tripler Army Medical Center, Honolulu, Hawaii
Honghung D. Nguyen
Affiliation:
Departments of Medicine and Clinical Investigation, Tripler Army Medical Center, Honolulu, Hawaii
Jeffery A. Mikita
Affiliation:
Departments of Medicine and Clinical Investigation, Tripler Army Medical Center, Honolulu, Hawaii
Cecilia P. Mikita
Affiliation:
Departments of Medicine and Clinical Investigation, Tripler Army Medical Center, Honolulu, Hawaii
Catherine F. T. Uyehara
Affiliation:
Departments of Medicine and Clinical Investigation, Tripler Army Medical Center, Honolulu, Hawaii
Duane R. Hospenthal
Affiliation:
Departments of Medicine and Clinical Investigation, Tripler Army Medical Center, Honolulu, Hawaii
*
Infectious Disease Service, Ward 63, Bldg 2, 6900 Georgia Ave NW, Washington, DC 20307
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Abstract

Objective:

To define the extent of nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to a tertiary-care hospital.

Design:

A blinded, prospective surveillance culture study of patients admitted to the hospital to determine the transmission (acquisition) rate of MRSA Risk factors associated with the likelihood of MRSA colonization on admission were investigated.

Setting:

Tertiary-care military medical facility.

Participants:

All patients admitted to the medicine, surgery, and pediatric wards, and to the medical, surgical, and pediatric intensive care units were eligible for inclusion.

Results:

Five hundred thirty-five admission and 374 discharge samples were collected during the study period. One hundred forty-one patients were colonized with methicillin-susceptible S. aureus (MSSA) and 20 patients (3.7%) were colonized with MRSA on admission. Of the 354 susceptible patients, 6 acquired MRSA during the study for a transmission rate of 1.7%. Patients colonized with MRSA on admission were more likely to be older than non-colonized or MSSA-colonized patients, to have received antibiotics within the past year, to have been hospitalized within the prior 3 years, or to have a known history of MRSA. Patients acquiring MRSA had an average hospital stay of 17.7 days compared with 5.3 days for those who did not acquire MRSA. Pulsed-field gel electrophoresis of the 6 MRSA isolates from patients who acquired MRSA revealed 4 distinct band patterns.

Conclusions:

Most patients colonized with MRSA were identified on admission samples. Surveillance cultures of patients admitted may help to prevent MRSA transmission and infection.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 6 , June 2003 , pp. 415 - 421
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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