Carriage of Multiple Subtypes of Methicillin-ResistantStaphylococcus aureusby Intensive Care Unit Patients

2006 ◽  
Vol 27 (10) ◽  
pp. 1063-1067 ◽  
Author(s):  
Megan S. C. Lim ◽  
Caroline L. Marshall ◽  
Denis Spelman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gel Electrophoresis ◽  
Tertiary Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Control Procedure ◽  
Anatomical Site ◽  
Single Patient ◽  
Infection Control Procedure ◽  
Over Time

Objective:To determine how consistently patients are colonized with methicillin-resistantStaphylococcus aureus(MRSA) at various sites and how many subtypes can be carried simultaneously by a single patient.Setting.A 28-bed Intensive care unit in a tertiary-care referral hospital.Methods.A total of 1,181 patients were screened by culture of swab specimens obtained from the nose, throat, groin, and axilla on admission to the intensive care unit (ICU), twice weekly during their ICU stay, and at discharge.Results.MRSA was isolated at least once from 224 patients. Of these isolates, 359 were selected from 32 patients to be subtyped using pulsed-field gel electrophoresis. The rate of compliance with collection of swab specimens was 79.9%. The combination of sites colonized varied frequently over time for many patients. Of patients who had swab specimens obtained twice in 1 day, 8.7% had discordant results from the 2 swab sets. No patient had a clinical isolate that was not of an identical subtype to an isolate from an anatomical site that was sampled for screening. Half the patients carried multiple subtypes during their stay, with up to 4 subtypes per patient.Conclusions.The findings of this study may indicate that these patients have been colonized with MRSA on more than one occasion, possibly because of multiple breaches in infection control procedure. In MRSA-colonized patients, anatomical sites were intermittently colonized and carriage of multiple subtypes was common. These findings indicate that MRSA carriage is not a fixed state but may vary over time.

scholarly journals TEM-24 Produced by Four Different Species ofEnterobacteriaceae, Including Providencia rettgeri, in a Single Patient

1999 ◽  
Vol 43 (8) ◽  
pp. 2069-2073 ◽  
Author(s):  
Helene Marchandin ◽  
Christian Carriere ◽  
Danielle Sirot ◽  
Helene Jean- Pierre ◽  
Helene Darbas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gel Electrophoresis ◽  
Pulsed Field Gel Electrophoresis ◽  
Conjugative Plasmid ◽  
Single Patient ◽  
Providencia Rettgeri ◽  
Pulsed Field ◽  
The Family ◽  
First Time

ABSTRACT Four species of members of the familyEnterobacteriaceae harboring extended-spectrum β-lactamase (ESBL) were recovered in a single patient hospitalized in an intensive care unit. Among these isolates, we describe for the first time an ESBL-producing Providencia rettgeri strain. Bacteria from the same species were shown to be genetically related by pulsed-field gel electrophoresis analysis. These strains produced the same TEM derivative ESBL, characterized as TEM-24. This enzyme had the peculiarity of being encoded by a large conjugative plasmid of 180 kb, never previously described for such an ESBL.

Pseudomonas aeruginosa Outbreak in a Neonatal Intensive Care Unit Attributed to Hospital Tap Water

2017 ◽  
Vol 38 (7) ◽  
pp. 801-808 ◽  
Author(s):  
Cara Bicking Kinsey ◽  
Samir Koirala ◽  
Benjamin Solomon ◽  
Jon Rosenberg ◽  
Byron F. Robinson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Gel Electrophoresis ◽  
Neonatal Intensive Care ◽  
Case Control Study ◽  
Case Control ◽  
Pulsed Field Gel Electrophoresis ◽  
Point Of Use ◽  
Control Study

OBJECTIVETo investigate an outbreak of Pseudomonas aeruginosa infections and colonization in a neonatal intensive care unit.DESIGNInfection control assessment, environmental evaluation, and case-control study.SETTINGNewly built community-based hospital, 28-bed neonatal intensive care unit.PATIENTSNeonatal intensive care unit patients receiving care between June 1, 2013, and September 30, 2014.METHODSCase finding was performed through microbiology record review. Infection control observations, interviews, and environmental assessment were performed. A matched case-control study was conducted to identify risk factors for P. aeruginosa infection. Patient and environmental isolates were collected for pulsed-field gel electrophoresis to determine strain relatedness.RESULTSIn total, 31 cases were identified. Case clusters were temporally associated with absence of point-of-use filters on faucets in patient rooms. After adjusting for gestational age, case patients were more likely to have been in a room without a point-of-use filter (odds ratio [OR], 37.55; 95% confidence interval [CI], 7.16–∞). Case patients had higher odds of exposure to peripherally inserted central catheters (OR, 7.20; 95% CI, 1.75–37.30) and invasive ventilation (OR, 5.79; 95% CI, 1.39–30.62). Of 42 environmental samples, 28 (67%) grew P. aeruginosa. Isolates from the 2 most recent case patients were indistinguishable by pulsed-field gel electrophoresis from water-related samples obtained from these case-patient rooms.CONCLUSIONSThis outbreak was attributed to contaminated water. Interruption of the outbreak with point-of-use filters provided a short-term solution; however, eradication of P. aeruginosa in water and fixtures was necessary to protect patients. This outbreak highlights the importance of understanding the risks of stagnant water in healthcare facilities.Infect Control Hosp Epidemiol 2017;38:801–808

Rapid Eradication of a Cluster ofSerratia marcescensin a Neonatal Intensive Care Unit: Use of Epidemiologic Chromosome Profiling by Pulsed-Field Gel Electrophoresis

2004 ◽  
Vol 25 (9) ◽  
pp. 730-734 ◽  
Author(s):  
Kwan Kew Lai ◽  
Stephen P. Baker ◽  
Sally A. Fontecchio
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Gel Electrophoresis ◽  
Neonatal Intensive Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Control Measures ◽  
Pulsed Field ◽  
Contact Precautions ◽  
Control Study

AbstractObjective:To investigate a cluster of patients infected and colonized withSerratia marcescensin a neonatal intensive care unit (NICU).Methods:In June 2001, two neonates in the NICU had clinical infections withS. marcescensand one died. Infection control surveillance data for the NICU revealed that S.marcescenswas rarely isolated from clinical specimens. Surveillance and environmental cultures were performed and isolates were typed using pulsed-field gel electrophoresis. Staff and neonates were cohorted and a waterless, alcohol-based handwashing agent was introduced. A case-control study was performed.Results:From June 2 through August 20, 2001, 11 neonates withS. marcescensinfection and colonization were identified. The incidence ofS. marcescensinfections increased from 0.19 per 1,000 patient-days in 2000 to 0.52 per 1,000 patient-days in 2001 (P< .0001). In the first 3 weeks of the investigation, there were 2 sets of patients and sinks with indistinguishable strains; however, in subsequent weeks, all isolates were of unique strains, signifying no further transmission of the two initial predominant strains. Neonates withS. marcescenswere more likely to have a lower gestational age and birth weight. There was no association between cases and healthcare workers (HCWs).Conclusions:A cluster ofS. marcescenswas quickly terminated after the introduction of preventive measures including cohorting of infected and colonized neonates and HCWs, contact precautions, surveillance cultures, and a waterless, alcohol-based hand antiseptic. Chromosomal typing determined that strains with an indistinguishable pattern were no longer present in the unit after control measures were implemented.

Outbreak ofSerratia marcescensInfection in a Neonatal Intensive Care Unit

2001 ◽  
Vol 22 (5) ◽  
pp. 303-305 ◽  
Author(s):  
G.A. Prasad ◽  
Paula G. Jones ◽  
Jacqueline Michaels ◽  
Jeffery S. Garland ◽  
Chandra R. Shivpuri
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Serratia Marcescens ◽  
Gel Electrophoresis ◽  
Neonatal Intensive Care ◽  
Community Hospital ◽  
Pulsed Field Gel Electrophoresis ◽  
Pulsed Field ◽  
Source Of Infection

AbstractWe report an outbreak ofSerratia marcescensinfection in the neonatal intensive care unit of a community hospital. The outbreak involved eight neonates, (five infected and three colonized), one of whom died. Pulsed-field gel electrophoresis confirmed that all isolates were identical strains. Cohorting and isolation of the infected neonates helped to control the outbreak. No environmental source of infection was found.

scholarly journals Application of Different Genotyping Methods forPseudomonas aeruginosa in a Setting of Endemicity in an Intensive Care Unit

1999 ◽  
Vol 37 (11) ◽  
pp. 3654-3661 ◽  
Author(s):  
Han Speijer ◽  
Paul H. M. Savelkoul ◽  
Marc J. Bonten ◽  
Ellen E. Stobberingh ◽  
Jeroen H. T. Tjhie
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gel Electrophoresis ◽  
Fragment Length Polymorphism ◽  
Rapd Analysis ◽  
Random Amplified Polymorphic Dna ◽  
Pulsed Field Gel Electrophoresis ◽  
Aflp Analysis ◽  
Typing Method ◽  
Strain Differentiation

Colonization with Pseudomonas aeruginosa was studied by taking serial swab specimens from the oropharynges and anuses and tracheal and gastric aspirates from patients in an intensive care unit during a 10-month period in a setting of endemicity. Nineteen (10%) of the 192 patients included in the study were colonized on admission, while another 30 (16%) patients acquired P. aeruginosawhile in the hospital. Typing of 353 isolates was performed by random amplified polymorphic DNA (RAPD) analysis, and 56 strains were selected for further typing by RAPD analysis, pulsed-field gel electrophoresis (PFGE), and amplified fragment length polymorphism (AFLP) analysis. By these methods, 42, 44, and 44 genotypes were found, respectively. Computer-aided cluster analysis indicated that similar groups of related isolates were obtained by each method. By taking admission periods into account, analysis of the typing results suggested cross-acquisition of P. aeruginosa for five patient pairs. The small number of transfers and the large number of genotypes found indicate that most P. aeruginosa strains were derived from the patients themselves. The numbers of observed typing patterns and band differences between related isolates were counted for each typing method. AFLP analysis with primers without a selective base proved to be the most discriminatory method, followed by PFGE, AFLP analysis (with one selective base), and RAPD analysis. On the basis of a comparison with established strain differentiation criteria for PFGE, the criteria for differentiation of P. aeruginosa by AFLP analysis are presented.

Pulsed Field Gel Electrophoresis types of Candida albicans isolates from an intensive care unit in a Tunisian hospital

2011 ◽  
Vol 69 (3) ◽  
pp. 289-294
Author(s):  
Nadia Khadraoui ◽  
Kalthoum Kallel ◽  
Ons Bouchami ◽  
Myriam Bouchakoua ◽  
Amira Kaouech ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Candida Albicans ◽  
Intensive Care ◽  
Gel Electrophoresis ◽  
Pulsed Field Gel Electrophoresis ◽  
Pulsed Field

Mupirocin for Controlling Methicillin-ResistantStaphylococcus Aureus: Lessons From a Decade of Use at a University Hospital

2005 ◽  
Vol 26 (7) ◽  
pp. 662-667 ◽  
Author(s):  
Adriana M. Vivoni ◽  
Kátia R. N. Santos ◽  
Márcia P. de-Oliveira ◽  
Marcia Giambiagi-deMarval ◽  
Adriana L. P. Ferreira ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Molecular Epidemiology ◽  
Gel Electrophoresis ◽  
Tertiary Care ◽  
Pulsed Field Gel Electrophoresis ◽  
University Hospital ◽  
Incidence Density ◽  
Mupirocin Resistance ◽  
Restricted Use ◽  
Over Time

AbstractBackground:From 1990 to 1995 at Hospital Universitario dementino Fraga Filho, patients colonized or infected with methicillin-resistantStaphylococcus aureus(MRSA) were treated with mupirocin to eliminate MRSA carriage. In 1995, 65% of MRSA patients at this hospital had mupirocin-resistant isolates. Starting in 1996, mupirocin use was restricted to patients colonized, but not infected, with MRSA.Objectives:To describe the use of mupirocin for controlling MRSA over a decade and to analyze the molecular epidemiology of mupirocin-resistant MRSA infections at this hospital.Setting:A 490-bed, tertiary-care university hospital.Methods:The incidence densities of patients with MRSA and acquisition of mupirocin by the hospital were calculated for the period 1992–2001.S. aureusisolates from 1999–2000 were analyzed by pulsed-field gel electrophoresis. Mupirocin-resistant MRSA isolates from 1994–1995 and 1999–2000 were analyzed forileS-2gene background polymorphisms.Results:The incidence density of MRSA patients increased slightly over time, whereas the purchase of mupirocin decreased dramatically. Mupirocin-resistant MRSA infections decreased from 65% in 1994–1995 to 15% in 1999–2000. The MRSA Brazilian clone, detected in 1992, was still highly prevalent. The sameileS-2 encoding plasmid found in 1994–1995 persisted in three identical MRSA isolates from 1999–2000 belonging to the Brazilian clone.Conclusions:After mupirocin use decreased, theileS-2 encoding plasmid persisted in only a few Brazilian clone isolates. Our data on mupirocin-resistant MRSA incidence and mupirocin use strongly suggested that restricted use was related to decreased rates of mupirocin resistance at our hospital. (Infect Control Hosp Epidemiol 2005;26:662-667)

Sign in / Sign up

Export Citation Format

Share Document