Publication: Acquisition and cross-transmission of Staphylococcus aureus in European intensive care units
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Identifiers
Date
2009-02
Authors
Bloemendaal, AL
Fluit, AC
Jansen, WM
Vriens, MR
Ferry, T
Argaud, L
Amorim, JM
Resende, AC
Pascual, A
López-Cerero, L
Advisors
Journal Title
Journal ISSN
Volume Title
Publisher
University of Chicago Press
Metrics
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Abstract
Objective. To study the acquisition and cross-transmission of Staphylococcus aureus in different intensive care units (ICUs). Methods. We performed a multicenter cohort study. Six ICUs in 6 countries participated. During a 3-month period at each ICU, all patients had nasal and perineal swab specimens obtained at ICU admission and during their stay. All S. aureus isolates that were collected were genotyped by spa typing and multilocus variable-number tandem-repeat analysis typing for cross-transmission analysis. A total of
629 patients were admitted to ICUs, and 224 of these patients were found to be colonized with S. aureus at least once during ICU stay (22% were found to be colonized with methicillin-resistant S. aureus [MRSA]). A total of 316 patients who had test results negative for S. aureus at ICU admission and had at least 1 follow-up swab sample obtained for culture were eligible for acquisition analysis. Results. A total of 45 patients acquired S. aureus during ICU stay (31 acquired methicillin-susceptible S. aureus [MSSA], and 14
acquired MRSA). Several factors that were believed to affect the rate of acquisition of S. aureus were analyzed in univariate and multivariate
analyses, including the amount of hand disinfectant used, colonization pressure, number of beds per nurse, antibiotic use, length of stay,
and ICU setting (private room versus open ICU treatment). Greater colonization pressure and a greater number of beds per nurse correlated
with a higher rate of acquisition for both MSSA and MRSA. The type of ICU setting was related to MRSA acquisition only, and the amount
of hand disinfectant used was related to MSSA acquisition only. In 18 (40%) of the cases of S. aureus acquisition, cross-transmission from
another patient was possible. Conclusions. Colonization pressure, the number of beds per nurse, and the treatment of all patients in private rooms correlated with the number of S. aureus acquisitions on an ICU. The amount of hand disinfectant used was correlated with the number of cases of MSSA acquisition but not with the number of cases of MRSA acquisition. The number of cases of patient-to-patient cross-transmission was
comparable for MSSA and MRSA.
Description
MeSH Terms
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection
Medical Subject Headings::Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial::Drug Resistance, Bacterial::Drug Resistance, Multiple, Bacterial
Medical Subject Headings::Disciplines and Occupations::Natural Science Disciplines::Biological Science Disciplines::Biology::Genetics::Molecular Biology::Molecular Epidemiology
Medical Subject Headings::Phenomena and Processes::Genetic Phenomena::Genotype
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Public Health Practice::Communicable Disease Control::Handwashing
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Personnel::Infection Control Practitioners
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospital Units::Intensive Care Units
Medical Subject Headings::Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Penicillins::Methicillin
Medical Subject Headings::Organisms::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus::Staphylococcus aureus::Methicillin-Resistant Staphylococcus aureus
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Clinical Laboratory Techniques::Microbiological Techniques::Microbial Sensitivity Tests
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Staphylococcal Infections
Medical Subject Headings::Organisms::Bacteria::Gram-Positive Bacteria::Gram-Positive Cocci::Staphylococcaceae::Staphylococcus::Staphylococcus aureus
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection
Medical Subject Headings::Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial::Drug Resistance, Bacterial::Drug Resistance, Multiple, Bacterial
Medical Subject Headings::Disciplines and Occupations::Natural Science Disciplines::Biological Science Disciplines::Biology::Genetics::Molecular Biology::Molecular Epidemiology
Medical Subject Headings::Phenomena and Processes::Genetic Phenomena::Genotype
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Public Health Practice::Communicable Disease Control::Handwashing
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Personnel::Infection Control Practitioners
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospital Units::Intensive Care Units
Medical Subject Headings::Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Penicillins::Methicillin
Medical Subject Headings::Organisms::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus::Staphylococcus aureus::Methicillin-Resistant Staphylococcus aureus
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Clinical Laboratory Techniques::Microbiological Techniques::Microbial Sensitivity Tests
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Staphylococcal Infections
Medical Subject Headings::Organisms::Bacteria::Gram-Positive Bacteria::Gram-Positive Cocci::Staphylococcaceae::Staphylococcus::Staphylococcus aureus
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
DeCS Terms
CIE Terms
Keywords
Cross-transmission, Staphylococcus aureus, Intensive care units, Transmisión cruzada, Estafilococi aureo, Unidades de cuidados intensivos
Citation
Bloemendaal AL, Fluit AC, Jansen WM, Vriens MR, Ferry T, Argaud L, et al.Acquisition and cross-transmission of Staphylococcus aureus in European intensive care units. Infect Control Hosp Epidemiol. 2009 Feb;30(2):117-24.