Dataset Information

Nasal colonization with methicillin-resistant Staphylococcus aureus among elderly living in nursing homes in Brazil: risk factors and molecular epidemiology.

ABSTRACT:

Background

Methicillin-resistant Staphylococcus aureus poses a threat to elderly living in nursing homes. Studies focusing on the epidemiology of colonization may help in the design of infection control strategies.

Objective

To identify factors associated with MRSA colonization and the dissemination of clones among nursing home residents.

Methods

Nasal swabs were collected from 300 persons from nine nursing homes in the city of Bauru, Brazil. Resistance to methicillin was identified through amplification of the mecA gene. Strain typing (Pulsed-Field Gel Electrophoresis) and characterization of the Staphylococcal Chromosome Cassette (SCC) mec was performed. Univariate and multivariable models were used to identify predictors of overall S. aureus and MRSA carriage.

Results

Rates of S. aureus and MRSA colonization were 17.7 and 3.7%, respectively. Age and recent admission to a hospital were independently associated with colonization with S. aureus. MRSA colonization was associated with living in small (< 15 residents) and medium-sized (15-49 residents) facilities, as well as with recent hospitalization. Most MRSA strains carried SCCmec types II or IV, and there was evidence of clonal spread within and among different facilities.

Conclusions

MRSA may be introduced in nursing homes form hospitals or arise from the community setting. Screening for asymptomatic colonization may identify persons with greater risk for infection, and is advised for residents discharged from acute care hospitals.

SUBMITTER: da Silveira M

PROVIDER: S-EPMC5934845 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Publications

Nasal colonization with methicillin-resistant Staphylococcus aureus among elderly living in nursing homes in Brazil: risk factors and molecular epidemiology.

da Silveira Monica M da Cunha Maria de Lourdes Ribeiro de Souza MLRS de Souza Camila Sena Martins CSM Correa Adriana Aparecida Feltrin AAF Fortaleza Carlos Magno Castelo Branco CMCB

Annals of clinical microbiology and antimicrobials 20180504 1

<h4>Background</h4>Methicillin-resistant Staphylococcus aureus poses a threat to elderly living in nursing homes. Studies focusing on the epidemiology of colonization may help in the design of infection control strategies.<h4>Objective</h4>To identify factors associated with MRSA colonization and the dissemination of clones among nursing home residents.<h4>Methods</h4>Nasal swabs were collected from 300 persons from nine nursing homes in the city of Bauru, Brazil. Resistance to methicillin was i ...[more]

PMID: 29728115

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Project description:BackgroundNursing home residents experience a large burden of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections. Data are limited regarding nursing home characteristics associated with differences in facility-level invasive MRSA rates.MethodsWe analyzed 2011-2015 data from CDC's Emerging Infections Program (EIP) active population- and laboratory-based surveillance for invasive MRSA cases within seven states. A nursing home-onset case was defined as MRSA cultured from a normally sterile site in a person living in a nursing home 3 days before culture collection. Facility rates were calculated as nursing home-onset cases per 100,000 resident-days. Nursing home resident-day denominators and facility characteristics were obtained from four Centers for Medicare & Medicaid Services (CMS) datasets. A general estimating equations model with a logit link assessed characteristics of the facilities with highest rates comprising 50% of nursing home MRSA cases ("high rates").ResultsThe 626 nursing homes in the surveillance area had 2824 invasive MRSA cases; 82% of facilities had at ≥1 case. The 20% of facilities with highest rates (≥3.84 cases/100,000 resident-days) had 50% of nursing home-onset cases. In multivariable regression, facilities with high rates were more likely to have CMS-derived characteristics of presence of a resident with a multidrug-resistant organism; or greater proportions of residents who were male, were short stay (in the facility <100 days), had a nasogastric or percutaneous gastrostomy tube, or require extensive assistance with bed repositioning; and more likely to be in an EIP area with higher hospital-onset MRSA rates. Higher registered nurses staffing levels (hours/resident/day) and higher proportions of White residents were associated with lower rates.ConclusionsFacilities with higher invasive MRSA rates served residents with more clinical and functional care needs. Increasing registered nurse staffing in high-risk facilities might assist with reduction of invasive MRSA rates. These findings could help prioritize nursing homes for future MRSA prevention work.

Project description:UnlabelledMethicillin-resistant Staphylococcus aureus (MRSA) is an important colonizer in animals and an opportunistic pathogen in humans. In humans, MRSA can cause infections that might be difficult to treat because of antimicrobial resistance. The use of bacteriophages has been suggested as a potential approach for the control of MRSA colonization to minimize the-often occupational-exposure of humans. The aim of this study was to assess the efficacy of bacteriophage treatment on porcine nasal colonization with MRSA in vitro, in vivo, and ex vivo. The effectiveness of a bacteriophage combination of phage K*710 and P68 was assessed in vitro by incubating them with MRSA V0608892/1 (ST398) measuring the OD600 hourly. To study the in vivo effect, bacteriophages were administered in a gel developed for human application, which contain 109 plaque-forming units (pfu)/mL (K and P68 in a 19.25:1 ratio) for 5 days to piglets (N = 8) that were experimentally colonized with the MRSA strain. Eight piglets experimentally colonized were used as a negative control. The MRSA strain was also used to colonize porcine nasal mucosa explants and bacteriophages were applied to assess the ex vivo efficacy of treatment. Bacteriophages were effective in vitro. In vivo, sixteen piglets were colonized with MRSA but the number of CFU recovered after the application of the bacteriophages in 8 piglets was not reduced compared to the control animals (approx. 105 CFU/swab). In the ex vivo model, 108 CFU were used to establish colonization with MRSA; a reduction of colonization was not observed after application of bacteriophages. However, application of mupirocin both in vivo and ex vivo resulted in a near eradication of MRSA.In conclusioni) The MRSA strain was killed in the presence of the bacteriophages phage K*710 and P68 in vitro. ii) Bacteriophages did not reduce porcine nasal colonization in vivo or ex vivo. Physiological in vivo and ex vivo conditions may explain these observations. Efficacy in the ex vivo model matched that of the in vivo system.

Dataset Information

Nasal colonization with methicillin-resistant Staphylococcus aureus among elderly living in nursing homes in Brazil: risk factors and molecular epidemiology.

Background

Objective

Methods

Results

Conclusions

Publications

Nasal colonization with methicillin-resistant Staphylococcus aureus among elderly living in nursing homes in Brazil: risk factors and molecular epidemiology.

Similar Datasets

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