Risk of acquiring antibiotic-resistant bacteria from prior room occupants.
TLDR
Admission to a room previously occupied by an MRSA-positive patient or a VRE- positive patient significantly increased the odds of acquisition for MRSA and VRE, and this route of transmission was a minor contributor to overall transmission.Abstract:
Background Environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) occurs during the care of patients harboring these organisms and may increase the risk of transmission to subsequent room occupants. Methods Twenty-month retrospective cohort study of patients admitted to 8 intensive care units performing routine admission and weekly screening for MRSA and VRE. We assessed the relative odds of acquisition among patients admitted to rooms in which the most recent occupants were MRSA positive or VRE positive, compared with patients admitted to other rooms. Results Of 11 528 intensive care unit room stays, 10 151 occupants were eligible to acquire MRSA, and 10 349 were eligible to acquire VRE. Among patients whose prior room occupant was MRSA positive, 3.9% acquired MRSA, compared with 2.9% of patients whose prior room occupant was MRSA negative (adjusted odds ratio, 1.4; P = .04). VRE, Among patients whose prior room occupant was VRE positive, these values were 4.5% and 2.8% respectively (adjusted odds ratio, 1.4; P = .02). These excess risks accounted for 5.1% of all incident MRSA cases and 6.8% of all incident VRE cases, with a population attributable risk among exposed patients of less than 2% for either organism. Acquisition was significantly associated with longer post–intensive care unit length of stay. Conclusions Admission to a room previously occupied by an MRSA-positive patient or a VRE-positive patient significantly increased the odds of acquisition for MRSA and VRE. However, this route of transmission was a minor contributor to overall transmission. The effect of current cleaning practices in reducing the risk to the observed levels and the potential for further reduction are unknown.read more
Citations
More filters
Journal ArticleDOI
Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic.
Michael Z. David,Robert S. Daum +1 more
TL;DR: This review details the epidemiology of CA-MRSA strains and the clinical spectrum of infectious syndromes associated with them that ranges from a commensal state to severe, overwhelming infection and addresses the therapy of these infections and strategies for their prevention.
Journal ArticleDOI
epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England
Heather Loveday,Jennie Wilson,Robert Pratt,Mana Golsorkhi,Alison Tingle,Aggie Bak,Jessica Browne,Jacqui Prieto,Mark H. Wilcox +8 more
TL;DR: These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence, and the synopses of evidence underpinning the guideline recommendations have been updated.
Journal ArticleDOI
A Review of the Research Literature on Evidence-Based Healthcare Design
Roger S. Ulrich,Craig Zimring,Xuemei Zhu,Jennifer R. DuBose,Hyun-Bo Seo,Young-Seon Choi,Xiaobo Quan,Anjali Joseph +7 more
TL;DR: This review found a growing body of rigorous studies to guide healthcare design, especially with respect to reducing the frequency of hospital-acquired infections and the state of knowledge of evidence-based healthcare design has grown rapidly in recent years.
Journal ArticleDOI
Methicillin-Resistant Staphylococcus aureus: Molecular Characterization, Evolution, and Epidemiology
Sahreena Lakhundi,Kunyan Zhang +1 more
TL;DR: The origin of MRSA is described, with emphasis on the diverse nature of staphylococcal cassette chromosome mec (SCCmec).
Journal ArticleDOI
Role of hospital surfaces in the transmission of emerging health care-associated pathogens: norovirus, Clostridium difficile, and Acinetobacter species.
TL;DR: Improved cleaning/disinfection of environmental surfaces and hand hygiene have been shown to reduce the spread of all of these pathogens, including norovirus and C difficile, which are relatively resistant to the most common surface disinfectants and waterless alcohol-based antiseptics.
References
More filters
Book
Generalized Linear Models
Peter McCullagh,John A. Nelder +1 more
TL;DR: In this paper, a generalization of the analysis of variance is given for these models using log- likelihoods, illustrated by examples relating to four distributions; the Normal, Binomial (probit analysis, etc.), Poisson (contingency tables), and gamma (variance components).
Journal ArticleDOI
Generalized Linear Models
TL;DR: In this paper, the authors used iterative weighted linear regression to obtain maximum likelihood estimates of the parameters with observations distributed according to some exponential family and systematic effects that can be made linear by a suitable transformation.
Journal ArticleDOI
CDC definitions for nosocomial infections, 1988
TL;DR: The Centers for Disease Control (CDC) developed a new set of definitions for surveillance of nosocomial infections as mentioned in this paper, which combine specific clinical findings with results of laboratory and other tests that include recent advances in diagnostic technology.
Journal ArticleDOI
Comparison of mortality associated with methicillin-resistant and methicillin-susceptible staphylococcus aureus bacteremia: A meta-analysis
Sara E. Cosgrove,George Sakoulas,Eli N. Perencevich,Mitchell J. Schwaber,Adolf W. Karchmer,Yehuda Carmeli,Yehuda Carmeli +6 more
TL;DR: A meta-analysis was performed to summarize the impact of methicillin-resistance on mortality in Staphylococcus aureus bacteremia and explored the reasons for heterogeneity by means of subgroup analyses.