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Accuracy of reporting of methicillin-resistant Staphylococcus aureus in a provincial quality control program: a 9-year study.

https://arctichealth.org/en/permalink/ahliterature221090
Source
J Clin Microbiol. 1993 May;31(5):1275-9
Publication Type
Article
Date
May-1993
Author
A M Mackenzie
H. Richardson
P. Missett
D E Wood
D J Groves
Author Affiliation
Department of Laboratory Medicine, Ottawa Civic Hospital, Ontario, Canada.
Source
J Clin Microbiol. 1993 May;31(5):1275-9
Date
May-1993
Language
English
Publication Type
Article
Keywords
Data Collection
Humans
Laboratories - standards
Methicillin Resistance
Microbial Sensitivity Tests - standards - statistics & numerical data
Ontario
Quality Control
Questionnaires
Sensitivity and specificity
Staphylococcus aureus - drug effects
Abstract
We report the results of a province-wide quality control program in which five methicillin-resistant Staphylococcus aureus strains were circulated to all Ontario laboratories (hospital, private, and public health laboratories) on nine occasions between 1980 and 1989. The level of expression of methicillin resistance in each of the isolates was determined by performing viable colony counts on serial dilutions of methicillin in agar, and each isolate was assigned to an expression class according to previous published criteria (A. Tomasz, S. Nachman, and H. Leaf, Antimicrob. Agents Chemother. 35:124-129, 1991). Over this time there was an improvement in the performance of laboratories in the recognition of three strains that were relatively easy to detect (strains B, C, and E). These strains were of expression class II, and 98% of laboratories reported correct identifications in 1986. Performance in identifying two strains (strains A and D) of expression class I remained poor. Strain A was circulated in two surveys in 1987 and 1989, and laboratories were sent a questionnaire requesting details of the methods used in those two surveys. The methods used by the laboratories were classified into three categories: disk diffusion, single-plate screening by agar incorporation, and automated methods, which included premanufactured MIC panels. Between the 1987 and 1989 surveys, there was no change in the performance of the disk diffusion test (60% correct on both occasions), but there was improvement in the sensitivity of the agar incorporation test (36% correct in 1987 and 84% correct in 1989) and in automated methods (43% correct in 1987 and 79% correct in 1989). Over a decade, there was overall improvement in the performance of laboratories in detecting easy-to-detect strains, but there were difficulties in detecting organisms of low expression class, and an organism of very low expression class should be designated as a control organism for routine testing of methicillin-resistant s. aureus isolates.
Notes
Cites: Antimicrob Agents Chemother. 1991 Jan;35(1):124-92014967
Cites: Diagn Microbiol Infect Dis. 1989 Sep-Oct;12(5):385-942533050
Cites: Antimicrob Agents Chemother. 1992 Jan;36(1):6-91590701
Cites: Antimicrob Agents Chemother. 1992 Jul;36(7):1367-731510429
Cites: Antimicrob Agents Chemother. 1992 Jul;36(7):1585-61510460
Cites: J Bacteriol. 1972 Feb;109(2):844-75058455
Cites: J Clin Microbiol. 1983 Nov;18(5):1084-916643661
Cites: J Clin Microbiol. 1983 Nov;18(5):1226-366605976
Cites: J Clin Microbiol. 1984 Jun;19(6):813-76565707
Cites: J Clin Microbiol. 1984 Sep;20(3):494-96490833
Cites: J Clin Microbiol. 1986 May;23(5):832-93011847
Cites: J Clin Microbiol. 1986 Nov;24(5):764-93639887
Cites: J Clin Microbiol. 1987 Apr;25(4):734-53571481
Cites: Am J Clin Pathol. 1987 Aug;88(2):231-53618554
Cites: Clin Microbiol Rev. 1988 Apr;1(2):173-863069195
Cites: N Engl J Med. 1989 May 4;320(18):1188-962651925
Cites: Antimicrob Agents Chemother. 1989 Jul;33(7):995-92675760
Cites: Antimicrob Agents Chemother. 1989 Nov;33(11):1869-742610497
Cites: Antimicrob Agents Chemother. 1992 Jan;36(1):25-311375449
PubMed ID
8501229 View in PubMed
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Active infective endocarditis due to methicillin-resistant Staphylococcus aureus in the acute phase of infectious mononucleosis.

https://arctichealth.org/en/permalink/ahliterature5151
Source
Jpn J Thorac Cardiovasc Surg. 2002 Jun;50(6):249-51
Publication Type
Article
Date
Jun-2002
Author
Hiroyuki Sakahashi
Arifumi Takazawa
Akihiko Toyama
Tadayuki Haida
Author Affiliation
Department of Cardiovascular Surgery, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama 362-8588, Japan.
Source
Jpn J Thorac Cardiovasc Surg. 2002 Jun;50(6):249-51
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Acute-Phase Reaction
Adult
Aortic Valve - surgery
Endocarditis, Bacterial - etiology - surgery
Heart Valve Prosthesis Implantation
Humans
Infectious Mononucleosis - complications
Male
Methicillin Resistance
Staphylococcal Infections
Staphylococcus aureus - drug effects
Abstract
A 26-year-old male was treated for acute hepatitis due to Epstein-Barr virus and infectious mononucleosis in our hospital. At 2 weeks after admission, there was relapse with high fever. A blood culture detected methicillin-resistant Staphylococcus aureus. A two-dimensional echocardiogram revealed severe aortic regurgitation and vegetation on the left coronary cusp of the aortic valve. The diagnosis was active infective endocarditis due to methicillin-resistant Staphylococcus aureus in the acute phase of infectious mononucleosis. Following preoperative administration of vancomycin, the aortic valve was replaced with a Carbomedics prosthetic valve. The aortic valve was bicuspid, and the right cusp and non-coronary cusp were conjoined. As the focus of infection was localized to the left coronary cusp, the infected tissue was fully removed with resection of all the cusps. Although fever persisted long after the operation, the blood culture became negative for methicillin-resistant Staphylococcus aureus, and repeated echocardiograms including transesophageal echocardiogram showed no prosthetic valve infection. Vancomycin was administered until the C-reactive protein became negative at 45 days after the operation.
PubMed ID
12073602 View in PubMed
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Adapting spa typing for national laboratory-based surveillance of methicillin-resistant Staphylococcus aureus.

https://arctichealth.org/en/permalink/ahliterature137554
Source
Eur J Clin Microbiol Infect Dis. 2011 Jun;30(6):789-97
Publication Type
Article
Date
Jun-2011
Author
A. Vainio
S. Koskela
A. Virolainen
J. Vuopio
S. Salmenlinna
Author Affiliation
Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare (THL), PO Box 30, 00271 Helsinki, Finland. anni.vainio@thl.fi
Source
Eur J Clin Microbiol Infect Dis. 2011 Jun;30(6):789-97
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Bacteremia - microbiology
Bacterial Typing Techniques - economics - methods
Cluster analysis
Electrophoresis, Gel, Pulsed-Field
Finland
Genotype
Humans
Methicillin-Resistant Staphylococcus aureus - classification - genetics - isolation & purification
Molecular Epidemiology - methods
Molecular Typing - economics - methods
Staphylococcal Infections - microbiology
Time Factors
Abstract
Laboratory-based surveillance of methicillin-resistant Staphylococcus aureus (MRSA) monitors the baseline occurrence of different genotypes and identifies strains and transmission chains responsible for outbreaks. The consequences of substituting pulsed-field gel electrophoresis (PFGE) with spa typing as a first-line typing method were analyzed by typing 589 strains isolated between 1997 and 2006, with a focus on both short- and long-term correspondence between the PFGE and spa typing results. The study, covering these ten years, included all Finnish MRSA blood isolates and representatives of the two most prevalent MRSA strains (PFGE types FIN-4 and FIN-16) in Finland. In addition, all sporadic isolates from 2006 were included. spa typing was more expensive but approximately four times faster to perform than PFGE. Nearly 90% of FIN-4 and FIN-16 isolates showed consistent spa types, t172 and t067, respectively. spa typing predicted the PFGE result of the blood isolates by a Wallace coefficient of 0.9009, recognized internationally successful strains (t041, t067) to be common also in Finland, and identified a separate cluster of isolates, also related in time and place among the FIN-4 strains. Additional typing by another method was needed to provide adequate discrimination or to characterize isolates with a newly recognized spa type in Finland.
PubMed ID
21271269 View in PubMed
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An investigation of methicillin-resistant Staphylococcus aureus colonization in people and pets in the same household with an infected person or infected pet.

https://arctichealth.org/en/permalink/ahliterature148824
Source
J Am Vet Med Assoc. 2009 Sep 1;235(5):540-3
Publication Type
Article
Date
Sep-1-2009
Author
Meredith C Faires
Kathy C Tater
J Scott Weese
Author Affiliation
Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
Source
J Am Vet Med Assoc. 2009 Sep 1;235(5):540-3
Date
Sep-1-2009
Language
English
Publication Type
Article
Keywords
Animals
Animals, Domestic
Canada - epidemiology
Carrier state
Cat Diseases - epidemiology - microbiology - transmission
Cats
Cross Infection
Dog Diseases - epidemiology - microbiology - transmission
Dogs
Family Characteristics
Humans
Methicillin-Resistant Staphylococcus aureus - isolation & purification
Staphylococcal Infections - epidemiology - microbiology - transmission - veterinary
United States - epidemiology
Zoonoses
Abstract
To investigate the prevalence of concurrent methicillin-resistant Staphylococcus aureus (MRSA) colonization in people and pets in the same household with a person or pet with an MRSA infection and to compare MRSA isolates by use of molecular techniques.
2 cross-sectional evaluations conducted concurrently.
24 dogs, 10 cats, and 56 humans in part 1 and 21 dogs, 4 cats, and 16 humans in part 2 of the study.
In both parts of the study, nasal swab specimens were collected from humans and nasal and rectal swab specimens were collected from household pets. Selective culture for MRSA was performed, and isolates were typed via pulsed-field gel electrophoresis (PFGE) and spa typing. Households were defined as positive when MRSA was isolated from at least 1 person (part 1) or 1 pet (part 2).
In part 1, 6 of 22 (27.3%) households were identified with MRSA colonization in a person. In these households, 10 of 56 (17.9%) humans, 2 of 24 (8.3%) dogs, and 1 of 10 (10%) cats were colonized with MRSA. In part 2, only 1 of 8 households was identified with MRSA colonization in a pet. Most MRSA isolates obtained from humans and pets in the same household were indistinguishable by use of PFGE.
The high prevalence of concurrent MRSA colonization as well as identification of indistinguishable strains in humans and pet dogs and cats in the same household suggested that interspecies transmission of MRSA is possible. Longitudinal studies are required to identify factors associated with interspecies transmission.
PubMed ID
19719444 View in PubMed
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An outbreak of community-onset methicillin-resistant Staphylococcus aureus skin infections in southwestern Alaska.

https://arctichealth.org/en/permalink/ahliterature30882
Source
Infect Control Hosp Epidemiol. 2003 Jun;24(6):397-402
Publication Type
Article
Date
Jun-2003
Author
Henry C Baggett
Thomas W Hennessy
Richard Leman
Cindy Hamlin
Dana Bruden
Alisa Reasonover
Patricia Martinez
Jay C Butler
Author Affiliation
Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska 99508, USA.
Source
Infect Control Hosp Epidemiol. 2003 Jun;24(6):397-402
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska - epidemiology
Anti-Bacterial Agents - therapeutic use
Child
Child, Preschool
Cohort Studies
Community-Acquired Infections - epidemiology
Disease Outbreaks
Female
Humans
Infant
Male
Methicillin Resistance
Middle Aged
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Retrospective Studies
Rural Population
Staphylococcal Skin Infections - drug therapy - epidemiology - microbiology
Staphylococcus aureus - isolation & purification
Abstract
OBJECTIVE: We investigated a large outbreak of community-onset methicillin-resistant Staphylococcus aureus (MRSA) infections in southwestern Alaska to determine the extent of these infections and whether MRSA isolates were likely community acquired. DESIGN: Retrospective cohort study. SETTING: Rural southwestern Alaska. PATIENTS: All patients with a history of culture-confirmed S. aureus infection from March 1, 1999, through August 10, 2000. RESULTS: More than 80% of culture-confirmed S. aureus infections were methicillin resistant, and 84% of MRSA infections involved skin or soft tissue; invasive disease was rare. Most (77%) of the patients with MRSA skin infections had community-acquired MRSA (no hospitalization, surgery, dialysis, indwelling line or catheter, or admission to a long-term-care facility in the 12 months before infection). Patients with MRSA skin infections were more likely to have received a prescription for an antimicrobial agent in the 180 days before infection than were patients with methicillin-susceptible S. aureus skin infections. CONCLUSIONS: Our findings indicate that the epidemiology of MRSA in rural southwestern Alaska has changed and suggest that the emergence of community-onset MRSA in this region was not related to spread of a hospital organism. Treatment guidelines were developed recommending that beta-lactam antimicrobial agents not be used as a first-line therapy for suspected S. aureus infections.
Notes
Comment In: Infect Control Hosp Epidemiol. 2003 Jun;24(6):392-612828313
PubMed ID
12828314 View in PubMed
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An outbreak of methicillin-resistant Staphylococcus aureus in a pediatric hospital--how it got away and how we caught it.

https://arctichealth.org/en/permalink/ahliterature227491
Source
Can J Infect Control. 1991;6(1):11-3
Publication Type
Article
Date
1991
Author
L. Romance
L. Nicolle
J. Ross
B. Law
Source
Can J Infect Control. 1991;6(1):11-3
Date
1991
Language
English
Publication Type
Article
Keywords
Child, Preschool
Cross Infection - epidemiology - prevention & control
Disease Outbreaks
Hospitals, Pediatric
Humans
Infant
Infection Control - methods
Manitoba - epidemiology
Methicillin Resistance
Staphylococcal Infections - epidemiology - prevention & control
Abstract
An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) occurred in a hospital without endemic MRSA, following the transfer of a patient colonized by MRSA from another hospital known to have a problem with endemic MRSA. Despite initial appropriate isolation and therapy to eradicate colonization of the organism, the index child relapsed 10 weeks after the last prior positive culture. Simultaneously, the organism was isolated from two other patients on the same ward, and subsequently at surgery from one child transferred to the neonatal intensive care nursery. Antimicrobial therapy for urinary tract infection likely impaired earlier identification of MRSA in the index case. Suppression with mupirocin rather than eradication may have resulted in inappropriate early discontinuation of infection control precautions. Control of the outbreak and eradication of the organism from all patients was successful after intensive surveillance and control measures, including strict isolation and cohorting. This outbreak suggests that infection control precautions and intensive screening of contacts, as well as positive cases, may be effective for control and eradication of MRSA from health care facilities with recent introduction of an epidemic strain.
PubMed ID
1824273 View in PubMed
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[An outbreak of methicillin-resistant Staphylococcus aureus infection in a maternity ward]

https://arctichealth.org/en/permalink/ahliterature86895
Source
Tidsskr Nor Laegeforen. 2008 Apr 17;128(8):933-5
Publication Type
Article
Date
Apr-17-2008
Author
Jenum Pål A
Walberg Mette
Rønning Else Johanne
Kristoffersen Marit
Author Affiliation
Seksjon for medisinsk mikrobiologi, Laboratoriesenteret, Sykehuset Asker og Baerum, 1309 Rud. pal.jenum@sabhf.no
Source
Tidsskr Nor Laegeforen. 2008 Apr 17;128(8):933-5
Date
Apr-17-2008
Language
Norwegian
Publication Type
Article
Keywords
Contact Tracing
Disease Outbreaks - prevention & control
Female
Humans
Infant, Newborn
Male
Methicillin Resistance
Norway - epidemiology
Obstetrics and Gynecology Department, Hospital
Pregnancy
Pregnancy Complications, Infectious - microbiology - prevention & control
Staphylococcal Infections - drug therapy - epidemiology - transmission
Staphylococcus aureus
Abstract
BACKGROUND: Staphylococcus aureus is a frequent cause of serious infections. Methicillin-resistant S. aureus (MRSA) are resistant to almost all types of beta-lactam antibiotics and therefore represent a substantial medical problem. MATERIAL AND METHOD: In April 2006, the Department of Obstetrics at the Asker and Baerum hospital had an outbreak of MRSA that affected four newborns. The source for the infection was sought among family members, other patients and employees, and eradication was attempted. RESULTS: An employee was identified as the probable infectious source. Subsequent investigation identified 13 individuals infected by the same MRSA clone, which was Panton-Valentine-leukocidin (PVL) positive and therefore clearly a pathogen. 10 of the patients had MRSA disease, with 21 months between the first and the last identified case. For 5 of 13 patients MRSA was still detectable after the first attempt of eradication. For 2 patients, including one of the newborns, eradication has so far been unsuccessful and a third patient has acquired a new abscess after one year. INTERPRETATION: Issues connected to MRSA-screening of close contacts and eradication are resource-demanding and require careful consideration of strategy, especially for small children and families with chronic MRSA carriers. Updated detailed national guidelines for MRSA management are needed.
PubMed ID
18431416 View in PubMed
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An outbreak of methicillin resistant Staphylococcus aureus on a burn unit: potential role of contaminated hydrotherapy equipment.

https://arctichealth.org/en/permalink/ahliterature192932
Source
Burns. 2001 Nov;27(7):681-8
Publication Type
Article
Date
Nov-2001
Author
J M Embil
J A McLeod
A M Al-Barrak
G M Thompson
F Y Aoki
E J Witwicki
M F Stranc
A M Kabani
D R Nicoll
L E Nicolle
Author Affiliation
Infection Control Unit, Health Sciences Centre, MS673, 820 Sherbrook Street, Manitoba, R3A 1R9, Winnipeg, Canada
Source
Burns. 2001 Nov;27(7):681-8
Date
Nov-2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Burns - therapy
Cross Infection - epidemiology - microbiology
Disease Outbreaks
Equipment Contamination
Female
Humans
Hydrotherapy - instrumentation
Male
Manitoba - epidemiology
Methicillin Resistance
Middle Aged
Staphylococcal Infections - epidemiology - microbiology
Staphylococcus aureus - isolation & purification
Abstract
To report a multi-institution outbreak caused by a single strain of methicillin-resistant Staphylococcus aureus (MRSA).
Between September 19 and November 20, 1996 an index case and five secondary cases of nosocomial MRSA occurred on a 26 bed adult plastic surgery/burn unit (PSBU) at a tertiary care teaching hospital. Between November 11 and December 23, 1996, six additional cases were identified at a community hospital. One of the community hospital cases was transferred from the PSBU. All strains were identical by pulsed-field gel electrophoresis. MRSA may have contributed to skin graft breakdown in one case, and delayed wound healing in others. Patients required 2 to 226 isolation days.
A hand held shower and stretcher for showering in the hydrotherapy room of the PSBU were culture positive for the outbreak strain, and the presumed means of transmission. Replacement of stretcher showering with bedside sterile burn wound compresses terminated the outbreak. The PSBU was closed to new admissions and transfers out for 11 days during the investigation. Seven of 12 patients had effective decolonization therapy.
Environmental contamination is a potential source of nosocomial MRSA transmission on a burn unit. Notification among institutions and community care providers of shared patients infected or colonized with an antimicrobial resistant microorganism is necessary.
PubMed ID
11600247 View in PubMed
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[An outbreak of MRSA in a nursing home in Oslo].

https://arctichealth.org/en/permalink/ahliterature153688
Source
Tidsskr Nor Laegeforen. 2008 Dec 4;128(23):2734-7
Publication Type
Article
Date
Dec-4-2008
Author
Hans Frederik Leendert van der Werff
Tore Waelgaard Steen
Kirsten Marie Knutsen Garder
Bjørg Marit Andersen
Mette Rasch
Bente Jørgen
Anne Bråthen
Merete Helland
Lina Torvund
Aslak Heldal Haugen
Author Affiliation
Hovseterhjemmet Landingsveien 12 0767 Oslo. hlfvanderwerff@hotmail.com
Source
Tidsskr Nor Laegeforen. 2008 Dec 4;128(23):2734-7
Date
Dec-4-2008
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Carrier State - microbiology
Disease Outbreaks
Female
Humans
Infection Control
Male
Methicillin-Resistant Staphylococcus aureus - isolation & purification
Middle Aged
Norway - epidemiology
Nursing Homes
Patient Isolation
Risk factors
Staphylococcal Infections - epidemiology - microbiology - transmission
Abstract
Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) represent an increasing problem in Norway, also in nursing homes and other institutions for long-term care. We describe an outbreak of MRSA in a nursing home in Oslo 2004-5.
The nursing home has six wards with 185 beds. The building is old, all rooms have toilets and sinks, but showers are shared. Standard screening procedures were carried out according to the national MRSA guide and by using the nursing home's infection control programme. Later on we used more extensive screening of staff and patients.
The outbreak started in a ward for short-term care, but spread to a ward for patients with dementia after some months. Ten patients, seven staff members and two relatives of infected persons were diagnosed with MRSA. All bacteria probably belonged to the same strain. Four staff members and five patients who were infected had pre-existing wounds or eczema. The nursing home was declared free of MRSA 20 months after the outbreak started, but one member of staff remained a carrier for two years, and one patient became a chronic carrier of MRSA. During the first six months, infected patients were restricted to their rooms, and standard eradication procedures were carried out for five days. Later on, we introduced cohort isolation for infected, exposed and recently treated patients, a different screening routine, a prolonged eradication procedure, restrictions on staff working elsewhere and more stringent precautions for visitors.
An old building and insufficient isolation procedures during the first phase of the outbreak contributed to spreading MRSA and prolonging the outbreak. Cohort isolation seemed to be the most important measure to control the outbreak. All nursing homes should have a designated single patient room for contact precautions. Long-term carriers of MRSA in nursing homes represent a big challenge.
PubMed ID
19079422 View in PubMed
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344 records – page 1 of 35.