Control of Methicillin-Resistant Staphylococcus aureus at a University Hospital: One Decade Later

1995 ◽  
Vol 16 (12) ◽  
pp. 686-696 ◽  
Author(s):  
John A. Jernigan ◽  
Mark A. Clemence ◽  
Geraldine A. Stott ◽  
Maureen G. Titus ◽  
Carolyn H. Alexander ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
University Hospital ◽  
Methicillin Resistant

Control of Methicillin-Resistant Staphylococcus aureus at a University Hospital: One Decade Later

1995 ◽  
Vol 16 (12) ◽  
pp. 686-696 ◽  
Author(s):  
John A. Jernigan ◽  
Mark A. Clemence ◽  
Geraldine A. Stott ◽  
Maureen G. Titus ◽  
Carolyn H. Alexander ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
University Hospital ◽  
Methicillin Resistant

scholarly journals 554. The Changing Epidemiology of Methicillin-Resistant Staphylococcus aureus Causing Bacteremia in Hiroshima, Japan During 2008–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S263-S263
Author(s):  
Hiroki Kitagawa ◽  
Junzo Hisatsune ◽  
Hiroki Ohge ◽  
Motoyuki Sugai
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Sccmec Type ◽  
University Hospital ◽  
Methicillin Resistant ◽  
Type Iv ◽  
Time Period ◽  
Invasive Infections ◽  
Toxic Shock Syndrome Toxin ◽  
Mrsa Strains

Abstract Background Recently, the Japanese intrinsic community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) clone (CA-MRSA/J), classified as sequence type (ST) 8 carrying staphylococcal cassette chromosome mec (SCCmec) type IVl (ST8-IVl), has been identified that causes invasive infections similar to those of USA300 clone. However, epidemiological information regarding epidemic CA-MRSA clones is limited in Japan. This study was performed to investigate the changing epidemiology of MRSA causing bacteremia in Japan. Methods We performed whole-genome sequencing of MRSA isolates causing bacteremia at Hiroshima University Hospital between January 2008 and December 2017. MRSA isolates were subjected to multilocus sequence typing, SCCmec typing and were analyzed for virulence factors. Clinical data of patients with MRSA bacteremia were analyzed. Results A total of 193 MRSA strains causing bacteremia were identified during the study period. Among these, most belonged to ST764-IIa (30%; 59 of 193) and ST5-IIa (26.9%; 52 of 193). The proportion of ST5-IIa MRSA decreased from 39.6% (42 of 106) in 2008–2012 to 11.5% (10 of 87) in 2013–2017, and that of ST764-IIa MRSA increased from 23.6% (25 of 106) to 39.1% (34 of 87) in the same time period. The proportion of CA-MRSA (MRSA carrying SCCmec type IV or V) increased from 28.3% (30 of 106) in 2008–2012 to 42.5% (37 of 87) in 2013–2017. In CA-MRSA strains, clonal complex (CC) 8-IV MRSA was predominant (76.1%; 51 of 67). Those belonging to CC8-IV MRSA isolates were ST380-IVc (18 of 51), ST8-IVl (CA-MRSA/J; 15 of 51), ST8-IVj (15 of 51), ST8-IVa (2 of 51), and ST4803-IVl (1 of 51). The rate of hospital-onset infections of ST380-IVc, ST8-IVl, and ST8-IVj were 83.3%, 46.7%, and 60%, respectively. In CA-MRSA/J strains, including their variants (e.g., ST4803-IVl), 14 of 16 strains (87.5%) carried genes for toxic shock syndrome toxin (tst-1), enterotoxin C (sec), and enterotoxin L (sel), while none of the ST380-IVc and ST8-IVj MRSA strains carried these genes. Conclusion During the study period of 10 years, predominant ST5-IIa MRSA causing hospital-onset infections was replaced by ST764-IIa MRSA. In CA-MRSA clone, ST380-IVc, ST8-IVl (CA-MRSA/J), and ST8-IVj were dominant and have already spread to the healthcare environment. Disclosures All authors: No reported disclosures.

Prevalence of multidrug-resistant organisms on palliative care patients in a university hospital–bound palliative care unit: A prospective cohort analysis

2020 ◽  
Vol 34 (6) ◽  
pp. 776-783 ◽  
Author(s):  
Tobias Georg Strapatsas ◽  
Viola Simons ◽  
Beniam Ghebremedhin ◽  
Parviz Ahmad-Nejad ◽  
Oliver Schmalz
Keyword(s):  
Staphylococcus Aureus ◽  
Palliative Care ◽  
Confidence Interval ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Cohort Analysis ◽  
Multidrug Resistant ◽  
Interquartile Range ◽  
University Hospital ◽  
Methicillin Resistant ◽  
Multidrug Resistant Organisms

Background: Multidrug-resistant organisms are a growing challenge and burden to patient care. To date, there are only data concerning the prevalence of methicillin-resistant Staphylococcus aureus infections. Thus, numbers of other multidrug-resistant organisms can only be extrapolated and inferred from more or less comparable cohorts. Aim: To evaluate the prevalence of multidrug-resistant organisms on palliative care in-patients. Design: A prospective cohort analysis Setting/participants: A University Hospital–bound palliative care unit, in which all patients admitted to the unit were screened for inclusion. Results: In total, 304 patients were included in this study. The prevalence for methicillin-resistant Staphylococcus aureus of 5.2% (95% confidence interval: 2.9%–8.4%), for vancomycin-resistant Enterococcus faecium of 10.5% (95% confidence interval: 7.2%–14.8%), for Ciprofloxacin-resistant-extended spectrum beta-lactamases isolates of 5.8% (95% confidence interval: 3.4%–9.3%) and Ciprofloxacin-resistant Carbapenem-resistant Gram-negative bacteria of 0.3% (95% confidence interval: 0%–1.3%) was calculated. Except for methicillin-resistant Staphylococcus aureus, patients carrying a multidrug-resistant organism had a significant longer duration of hospitalization. Median length of stay was 12 days (interquartile range: 14.5, no multidrug-resistant organisms), 14.5 days (interquartile range: 15, methicillin-resistant Staphylococcus aureus), 21 days (interquartile range: 16.5, vancomycin-resistant enterococci), 22 days (interquartile range: 20.75, Ciprofloxacin-resistant-extended spectrum beta-lactamases) and 32 days (interquartile range: 22.00) for patients carrying two organisms. Conclusion: There is a high prevalence of all multidrug-resistant organisms within the hospitalized palliative care patients. However, the multidrug-resistant organisms do not seem to impact the survival within this cohort. Further studies should evaluate additional end-points, for example, quality of life, which are of special interest in this cohort.

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