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
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Microbial transmission in an outpatient clinic and impact of an intervention with an ethanol-based disinfectant.
Kelly A. Reynolds,Jonathan D. Sexton,Trevor Pivo,Kyle Humphrey,Rachel A. Leslie,Charles P. Gerba +5 more
TL;DR: Microbes spread quickly in an outpatient clinic, reaching maximum contamination levels 2 hours after inoculation, with the highest contamination on examination room door handles and nurses’ station chairs.
Journal ArticleDOI
Impact of a multi-hospital intervention utilising screening, hand hygiene education and pulsed xenon ultraviolet (PX-UV) on the rate of hospital associated meticillin resistant Staphylococcus aureus infection
TL;DR: Implementing a PX-UV device in conjunction with active screening and hand hygiene was associated with a decrease in HA-MRSA rates, a novel approach to MRSA prevention at an acute care hospital system in Greensboro, NC, USA.
Journal ArticleDOI
Exposure to WHO AWaRe antibiotics and isolation of multi-drug resistant bacteria: a systematic review and meta-analysis.
Giorgia Sulis,Sena Sayood,Shashi Katukoori,Neha Bollam,Ige Abraham George,Lauren H Yaeger,Miguel A. Chavez,Emmanuel Kofi Tetteh,Sindhu Yarrabelli,Céline Pulcini,Stéphan Juergen Harbarth,Dominik Mertz,Mike Sharland,Lorenzo Moja,Benedikt Huttner,Sumanth Gandra +15 more
TL;DR: A systematic review of the literature and estimate associations between prior exposure to antibiotics across AWaRe categories (Access, Watch, Reserve) and isolation of critical and high-priority multidrug resistant organisms (MDROs) on the WHO priority pathogen list is presented in this paper .
Journal ArticleDOI
Introduction of NGS in Environmental Surveillance for Healthcare-Associated Infection Control.
Manola Comar,Maria D'Accolti,Carolina Cason,Irene Soffritti,Giuseppina Campisciano,Luca Lanzoni,Matteo Bisi,Antonella Volta,Sante Mazzacane,Elisabetta Caselli +9 more
TL;DR: Next-generation sequencing could be an effective method for hospital environment monitoring, especially if flanked by PCR for species identification and resistome characterization, providing a potential tool for the control of HAI transmission.
Journal ArticleDOI
Transmission of health care-associated infections from roommates and prior room occupants: a systematic review
TL;DR: Although the majority of studies suggest a link between exposure to infected/colonized roommates and prior room occupants, methodological improvements such as increasing the statistical power and conducting universal screening for colonization would provide more definitive evidence needed to establish causality.
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