The Best Hospital Practices for Controlling Methicillin-Resistant Staphylococcus Aureus: On the Cutting Edge

2002 ◽  
Vol 23 (2) ◽  
pp. 69-76 ◽  
Author(s):  
Meredith S. Arnold ◽  
Jane M. Dempsey ◽  
Marlene Fishman ◽  
Patricia J. McAuley ◽  
Cynthia Tibert ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Rhode Island ◽  
Task Force ◽  
Chief Executive ◽  
Scientific Data ◽  
Methicillin Resistant ◽  
Department Of Health ◽  
Hospital Infection Control ◽  
Hospital Practices

Objective:A performance improvement task force of Rhode Island infection control professionals was created to develop an epidemiologic model of statewide consistent infection control practices that could reduce the spread of methicillin-resistant Staphylococcus aureus (MRSA).Design:This model encompasses screening protocols, isolation techniques, methods of cohorting positive patients, decolonization issues, postexposure follow-up, microbiology procedures, and standardized surveillance methodologies. These “best practice guidelines” include three categories of recommendations that define priority levels based on the availability of scientific data.Setting:From 1995 through 2000, several Rhode Island hospitals experienced a fivefold increase in nosocomial acquisition of MRSA.Participants:Rhode Island infection control professionals are a highly interactive group in the unique position of sharing patients and ultimately experiencing similar trends and problems.Intervention:The task force collaborated on developing the best hospital infection control practices to prevent and control the spread of MRSA in Rhode Island.Results:The task force met with local infectious disease physicians and representatives from the Rhode Island Department of Health, the Hospital Association of Rhode Island, and Rhode Island Quality Improvement Partners. Discussions identified numerous and diverse MRSA control practices, issues of consensus, and approaches to resolving controversial methods of reducing the spread of MRSA The guidelines regarding the best hospital practices for controlling MRSA were finalized 8 months later.Conclusion:These guidelines were distributed to all chief executive officers of Rhode Island hospitals by the Rhode Island Department of Health in December 2001. They were issued separate and apart from any regulations, with the intent that hospitals will adopt them as best hospital practices in an attempt to control MRSA.

“The Coccus-Conscious” or “The Conscious Careful”

1987 ◽  
Vol 8 (1) ◽  
pp. 34-35 ◽  
Author(s):  
Albert F. Brown ◽  
Joan L. Otterman
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Hospital Infection ◽  
Methicillin Resistant ◽  
Persistent Problem ◽  
Control Programs ◽  
Hospital Infection Control ◽  
To Come

Staphylococcus aureus continues to be a resilient and persistent problem for hospital infection control programs. Now methicillin-resistant S. aureus (MRSA) is emerging as an even more formidable foe, bringing with it controversies in laboratory reporting, treatment, and isolation strategies.History suggests that the best solution to the hospital bacteria problem may well lie in the realm of spirit more than material methods. So, in the manner of Dickens' Christmas Carol fantasy, let us travel with three spirits— the Spirit of Conscience Past, the Spirit of Conscience Present, and the Spirit of Conscience to Come.

scholarly journals Evaluation of the Effectiveness of Common Hospital Hand Disinfectants Against Methicillin-ResistantStaphylococcus aureus,Glycopeptide-Intermediate S.aureus,and Heterogeneous Glycopeptide-IntermediateS. aureus

2009 ◽  
Vol 30 (3) ◽  
pp. 226-232 ◽  
Author(s):  
Mandy Wootton ◽  
Timothy R. Walsh ◽  
Eleri M. Davies ◽  
Robin A. Howe
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Control Measures ◽  
Glycopeptide Resistance ◽  
Methicillin Resistant ◽  
Significant Challenge ◽  
Minimum Inhibitory Concentrations ◽  
Infection Control Measures ◽  
Hospital Infection Control ◽  
Mssa Strain

Background.The presence of methicillin-resistantStaphylococcus aureus(MRSA) and glycopeptide-intermediateS. aureus(GISA) in hospitals poses a significant challenge to hospital infection control teams. The use of disinfectants for both surface and hand cleaning is an essential part of the infection control measures.Objective.To evaluate the effectiveness of common hospital hand disinfectants against MRSA, GISA, and heterogeneous GISA (hGISA).Methods.For methicillin-susceptible S.aureus(MSSA), MRSA, GISA, and hGISA, the levels of susceptibility to hand disinfectants and their active ingredients were determined. Suspension tests were performed on commercial handwashing products.Results.Minimum inhibitory concentrations (MICs) of 2-propanol, Chlorhexidine, and hexachlorophene were similar for all phenotypes. The MICs of cetrimide and triclosan were higher for the MRSA, GISA, and hGISA strains than for the MSSA strain. The MICs for the chlorhexidine-containing agents Hibisol and Hibiscrub (AstraZeneca) and for the propanol-containing agent Sterillium (Medline) were 1-2-fold lower for the MSSA strains than for the MRSA, GISA, and hGISA strains. Suspension tests showed that the GISA and hGISA strains were less susceptible to the triclosan-containing agent Aquasept (SSL) than were the MRSA and MSSA strains, with resistance increasing with glycopeptide resistance. Products containing Betadine (Purdue) were more effective against the GISA and hGISA strains than against the MRSA and MSSA strains, especially after the strain was exposed to the product for 30 seconds.Conclusions.Using the EN 1040 standard criteria for the performance of disinfectants, we determined that all agents, except 50% Aquasept for hGISA and 0.33% hexachlorophene for GISA, performed effectively. However, the GISA and hGISA strains were less susceptible to triclosan-containing products, compared with the MRSA stains, but were more susceptible to products containing Betadine.

Observations Relating to an Inter-Hospital Outbreak of Methicillin-Resistant Staphylococcus aureus: Role of Antimicrobial Therapy in Infection Control

1981 ◽  
Vol 2 (6) ◽  
pp. 453-459 ◽  
Author(s):  
Thomas T. Ward ◽  
Rick E. Winn ◽  
Alan I. Hartstein ◽  
David L. Sewell
Keyword(s):  
Staphylococcus Aureus ◽  
Risk Factor ◽  
Infection Control ◽  
Antimicrobial Therapy ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Control Analysis ◽  
Methicillin Resistant ◽  
Hospital Outbreak ◽  
Hospital Infection Control

AbstractClinical, bacteriologie, epidemiologic and hospital infection-control observations related to an inter-hospital outbreak of methicillin-resistant Staphylococcus aureus are described. The outbreak involved 66 patients at the University of Oregon Health Sciences Center (UOHSC) and its closely affiliated VA hospital, the Portland VA Medical Center (PVAMC). No environmental source of infection was identified; person-to-person transmission was most likely responsible for its spread. Surveillance cultures demonstrated nasal colonization in house staff and nursing personnel at both hospitals. Inter-hospital transfer of infection was, in all likelihood, achieved via nasal carriage by a single physician. Case-control analysis indicated a significantly increased risk (p < 0.05) of acquisition of infection related to age, number of days hospitalized, severity of underlying disease and number of invasive procedures. Prior antibiotic receipt was a significant risk factor when analyzed by univariate analysis (p < 0.01), but, in contrast to previous studies, this was not a significant risk factor (p > 0.05) when related variables were controlled by multivariate analysis. Prevention of spread of infection by routine infection control measures was less effective at PVAMC than at UOHSC. Patients at PVAMC were significantly older and had longer durations of hospitalization (p < 0.05). Antimicrobial therapy of colonized patients and personnel appeared to assist in the control of the outbreak at PVAMC. Antimicrobial therapy with topical bacitracin and oral rifampin, alone or in combination with oral trimethoprim-sulfamethoxazole, was effective in eliminating colonization with methicillin-resistant S. aureus. [Infect Control 1981; 2(6):453-459.]

scholarly journals Understanding the Local Epidemiology of Methicillin-Resistant Staphylococcus aureus by Pulsed-Field Gel Electrophoresis in an Indian Tertiary Care Centre

2021 ◽  
Author(s):  
Avinandan Saha ◽  
Priyanka Prasad ◽  
Gita Nataraj
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Gel Electrophoresis ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Methicillin Resistant ◽  
Pulsed Field ◽  
Hospital Infection Control ◽  
Prospective Longitudinal

Abstract Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of community and hospital-acquired infections (HAIs). In the year preceding this study, our laboratory reported an MRSA isolation rate of 2% from 50,549 specimens. Molecular typing of MRSA identifies sources of infection, transmission chains and informs infection control practices, and pulsed-field gel electrophoresis (PFGE) is the gold standard. This study was conducted to gain an understanding of the local molecular epidemiology of MRSA in our hospital using PFGE, to inform hospital infection control practices.Methods: This prospective longitudinal study was conducted in the microbiology laboratory of our 2,200-bed tertiary care teaching hospital in Mumbai, India.The antibiotic susceptibility profiles and pulsed-field profiles (PFPs) of 100 consecutive non-duplicate clinical isolates of MRSA were obtained. The PFPs were compared to check for relatedness of isolates. The distribution of various pulsotypes across disciplines and hospital locations was examined.Results: Clinical specimens accounted for 86 (86%) of the MRSA isolates, whilst 14 (14%) were from screening of healthcare workers. Maximum isolates, 68 (68%), were from surgical disciplines. Confirmed HAIs accounted for 25 (25%) MRSA isolates. Seventeen antibiotypes were obtained and there was no correlation between antibiotype and pulsotype. Totally 43 pulsotypes were identified, with most isolates, 40 (40%), belonging to pulsotype 1. Seven clusters were identified. Cluster I had maximum pulsotypes, 14, and 58 (58%) isolates. Isolates belonging to clusters I and II were found in all hospital locations. Relatedness was observed between isolates from HAIs and screening specimens, and between community and HAI isolates.Conclusions: PFGE typing revealed the disciplines at greatest risk from MRSA in our hospital. The commonality between MRSA isolated from HAIs and screening of healthcare workers, and between MRSA isolated from HAIs and from community-acquired infections highlighted the horizontal transmission of MRSA and the need to reinforce infection control measures to limit this.

scholarly journals Emergence and dissemination of the methicillin resistant Staphylococcus aureus USA300 clone in Denmark (2000-2005)

2007 ◽  
Vol 12 (2) ◽  
pp. 3-4 ◽  
Author(s):  
A R Larsen ◽  
M Stegger ◽  
R V Goering ◽  
M Sørum ◽  
R Skov
Keyword(s):  
United States ◽  
Staphylococcus Aureus ◽  
Infection Control ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Sccmec Type ◽  
The United States ◽  
Molecular Characteristics ◽  
Methicillin Resistant ◽  
Hospital Infection Control ◽  
Invasive Infections

The problem of methicillin resistant Staphylococcus aureus (MRSA) is increasing worldwide, and the spread of MRSA in the community challenges infection control since it is no longer restricted to hospital settings but involves private homes, places of work and kindergartens [1]. Furthermore, community acquired (CA)-MRSA may circumvent existing hospital infection control, since patients are rarely screened at admission. In the United States, the predominant CA-MRSA is defined by the Center for Disease Control (CDC) as the USA300 (ST8) clone. USA300 primarily causes skin and soft tissue infections (SSTI) in the community [2], but healthcare acquired infections with USA300 are rapidly emerging in the United States [3,4]. Comparison of the Danish collection of MRSA from 1997-2005 with the USA300 reference strain showed that USA300 has been introduced into Denmark on several occasions. Between 2000 and 2005, we identified 44 isolates which in addition to identical pulsed-field gel electrophoresis (PFGE) pattern shared other molecular characteristics with USA300: spa type t008 or closely related variants, Panton-Valentine leukocidin (PVL) positive and Staphylococcal Cassette Chromosome mec (SCCmec) type IVa. The isolates primarily caused SSTI, but cases of invasive infections were also encountered. The number of USA300 has increased several-folds in Denmark from 2003 to 2005 (2, 11 and 28 new cases, respectively) and with the experience from the US in mind, this is of great concern, especially as it is observed in a country with a long reputation for controlling MRSA.

scholarly journals Methicillin-Resistant Staphylococcus aureus Recovered from Healthcare- and Community-Associated Infections in Egypt

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Mohamed Abdel-Maksoud ◽  
Mona El-Shokry ◽  
Ghada Ismail ◽  
Soad Hafez ◽  
Amani El-Kholy ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Continuous Monitoring ◽  
Inhibitory Concentration ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
The Past ◽  
Mrsa Strains ◽  
Healthcare Associated ◽  
Over Time

Background. Methicillin-resistant Staphylococcus aureus (MRSA) has created significant epidemiological, infection-control, and therapeutic management challenges during the past three decades. Aim. To analyze the pattern of resistance of healthcare- and community-associated MRSA in Egypt and the trend of resistance of HA-MRSA over time (2005–2013). Methods. MRSA isolates were recovered from healthcare-associated (HA) and community-associated (CA) Staphylococcus aureus (S. aureus) infections. They were tested against 11 antimicrobial discs and the minimal inhibitory concentration (MIC) of vancomycin was determined. Inducible clindamycin resistance (iMLSB) was also screened using D-test. Findings. Of 631 S. aureus, MRSA was identified in 343 (76.6%) and 21 (11.5%) of HA and CA S. aureus isolates, respectively. The proportion of HA-MRSA increased significantly from 48.6% in 2005 to 86.8% in 2013 (p value < 0.001). Multidrug resistance (MDR) was observed in 85.8% of HA-MRSA and 48.6% of CA-MRSA. Vancomycin intermediate resistant S. aureus (VISA) was detected in 1.2% of HA-MRSA and none was detected in CA-MRSA. Among HA-MRSA strains, 5.3% showed iMLSB compared to 9.5% among CA-MRSA. Conclusion. The upsurge of the prevalence rates of HA-MRSA over time is alarming and urges for an effective infection control strategy and continuous monitoring of antimicrobial use.

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