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Colonization Sites of USA300 Methicillin-Resistant Staphylococcus aureus in Residents of Extended Care Facilities

Published online by Cambridge University Press:  02 January 2015

Simone M. Shurland ,
O. Colin Stine ,
Richard A. Venezia ,
Jennifer K. Johnson ,
Min Zhan ,
Jon P. Furuno ,
Ram R. Miller ,
Tamara Johnson  and
Mary-Claire Roghmann
Simone M. Shurland
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
O. Colin Stine
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Richard A. Venezia
Affiliation:
Pathology, Baltimore, Maryland
Jennifer K. Johnson
Affiliation:
Pathology, Baltimore, Maryland
Min Zhan
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Jon P. Furuno
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Ram R. Miller
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Tamara Johnson
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Mary-Claire Roghmann*
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland University of Maryland School of Medicine, and Veterans Affairs Maryland Health Care System, Baltimore, Maryland
*
100 N. Greene St., Lower Level, Baltimore, MD 21201 (mroghman@epi.umaryland.edu)
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Abstract

Background.

The anterior nares are the most sensitive single site for detecting methicillin-resistant Staphylococcus aureus (MRSA) colonization. Colonization patterns of USA300 MRSA colonization are unknown.

Objectives.

To assess whether residents of extended care facilities who are colonized with USA300 MRSA have different nares or skin colonization findings, compared with residents who are colonized with non-USA300 MRSA strains.

Methods.

The study population included residents of 5 extended care units in 3 separate facilities who had a recent history of MRSA colonization. Specimens were obtained weekly for surveillance cultures from the anterior nares, perineum, axilla, and skin breakdown (if present) for 3 weeks. MRSA isolates were categorized as USA300 MRSA or non-USA300 MRSA.

Results.

Of the 193 residents who tested positive for MRSA, 165 were colonized in the anterior nares, and 119 were colonized on their skin. Eighty-four percent of USA300 MRSA-colonized residents had anterior nares colonization, compared with 86% of residents colonized with non-USA300 MRSA (P = .80). Sixty-six percent of USA300 MRSA–colonized residents were colonized on the skin, compared with 59% of residents colonized with non-USA300 MRSA (P = .30).

Conclusions.

Colonization patterns of USA300 MRSA and non-USA300 MRSA are similar in residents of extended care facilities. Anterior nares cultures will detect most—but not all—people who are colonized with MRSA, regardless of whether it is USA300 or non-USA300 MRSA.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 4 , April 2009 , pp. 313 - 318
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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References

1.Kourbatova, EV, Halvosa, JS, King, MD, Ray, SM, White, N, Blumberg, HM. Emergence of community-associated methicillin-resistant Staphylococcus aureus USA300 clone as a cause of health care-associated infections among patients with prosthetic joint infections. Am J Infect Control 2005;33:385–391.Google Scholar
2.Carleton, HA, Diep, BA, Charlebois, ED, Sensabaugh, GF, Perdreau-Remington, F. Community-adapted methicillin-resistant Staphylococcus aureus (MRSA): population dynamics of an expanding community reservoir of MRSA. J Infect Dis 2004;190:1730–1738.Google Scholar
3.Naimi, TS, LeDell, KH, Como-Sabetti, K, et al.Comparison of community-and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA 2003;290:2976–2984.Google Scholar
4.Fridkin, SK, Hageman, JC, Morrison, M, et al.Methicillin-resistant Staphylococcus aureus disease in three communities. N Engl J Med 2005;352:1436–1444.Google Scholar
5.Healy, CM, Hulten, KG, Palazzi, DL, Campbell, JR, Baker, CJ. Emergence of new strains of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit. Clin Infect Dis 2004;39:1460–1466.Google Scholar
6.Seybold, U, Kourbatova, EV, Johnson, JG, et al.Emergence of community-associated methicillin-resistant Staphylococcus aureus USA300 genotype as a major cause of health care-associated blood stream infections. Clin Infect Dis 2006;42:647–656.Google Scholar
7.Klevens, RM, Edwards, JR, Tenover, FC, McDonald, LC, Horan, T, Gaynes, R. Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992-2003. Clin Infect Dis 2006;42:389–391.Google Scholar
8.Klevens, RM, Morrison, MA, Fridkin, SK, et al.Community-associated methicillin-resistant Staphylococcus aureus and healthcare risk factors. Emerg Infect Dis 2006;12:1991–1993.Google Scholar
9.Saiman, L, O'Keefe, M, Graham, PL 3rdet al.Hospital transmission of community-acquired methicillin-resistant Staphylococcus aureus among postpartum women. Clin Infect Dis 2003;37:1313–1319.Google Scholar
10.Diep, BA, Gill, SR, Chang, RF, et al.Complete genome sequence of USA300, an epidemic clone of community-acquired methicillin-resistant Staphylococcus aureus. Lancet 2006;367:731–739.Google Scholar
11.McDougal, LK, Steward, CD, Killgore, GE, Chaitram, JM, McAllister, SK, Tenover, FC. Pulsed-field gel electrophoresis typing of oxacillin-resistant Staphylococcus aureus isolates from the United States: establishing a national database. J Clin Microbiol 2003;41:5113–5120.Google Scholar
12.Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L. Management of multidrug-resistant organisms in health care settings, 2006. Am J Infect Control 2007;35:S165–S193.Google Scholar
13.Muto, CA, Jernigan, JA, Ostrowsky, BE, et al.SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and Enterococcus. Infect Control Hosp Epidemiol 2003;24:362–386.Google Scholar
14.Sanford, MD, Widmer, AF, Bale, MJ, Jones, RN, Wenzel, RP. Efficient detection and long-term persistence of the carriage of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 1994;19:1123–1128.Google Scholar
15.Kluytmans, J, van Belkum, A, Verbrugh, H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 1997;10:505–520.Google Scholar
16.Miller, LG, Diep, BA. Clinical practice: colonization, fomites, and virulence: rethinking the pathogenesis of community-associated methicillin-resistant Staphylococcus aureus infection. Clin Infect Dis 2008;46:752–760.Google Scholar
17.Frazee, BW, Lynn, J, Charlebois, ED, Lambert, L, Lowery, D, Perdreau-Remington, F. High prevalence of methicillin-resistant Staphylococcus aureus in emergency department skin and soft tissue infections. Ann Emerg Med 2005;45:311–320.Google Scholar
18.Kazakova, SV, Hageman, JC, Matava, M, et al.A clone of methicillin-resistant Staphylococcus aureus among professional football players. N Engl J Med 2005;352:468–475.Google Scholar
19.Harmsen, D, Claus, H, Witte, W, Rothganger, J, Turnwald, D, Vogel, U. Typing of methicillin-resistant Staphylococcus aureus in a university hospital setting by using novel software for spa repeat determination and database management. J Clin Microbiol 2003;41:5442–5448.Google Scholar
20.Johnson, JK, Khoie, T, Shurland, S, Kreisel, K, Stine, OC, Roghmann, MC. Skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus USA300 clone. Emerg Infect Dis 2007;13:1195–1200.Google Scholar
21.Goering, RV, McDougal, LK, Fosheim, GE, Bonnstetter, KK, Wolter, DJ, Tenover, FC. Epidemiologic distribution of the arginine catabolic mobile element among selected methicillin-resistant and methicillin-susceptible Staphylococcus aureus isolates. J Clin Microbiol 2007;45:1981–1984.CrossRefGoogle ScholarPubMed
22.Sewell, DL, Potter, SA, Jacobson, CM, Strausbaugh, LJ, Ward, TT. Sensitivity of surveillance cultures for the detection of methicillin-resistant Staphylococcus aureus in a nursing-home-care unit. Diagn Microbiol Infect Dis 1993;17:53–56.Google Scholar
23.Girou, E, Pujade, G, Legrand, P, Cizeau, F, Brun-Buisson, C. Selective screening of carriers for control of methicillin-resistant Staphylococcus aureus (MRSA) in high-risk hospital areas with a high level of endemic MRSA. Clin Infect Dis 1998;27:543–550.Google Scholar
24.Lucet, JC, Chevret, S, Durand-Zaleski, I, Chastang, C, Regnier, B. Prevalence and risk factors for carriage of methicillin-resistant Staphylococcus aureus at admission to the intensive care unit: results of a multicenter study. Arch Intern Med 2003;163:181–188.Google Scholar