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Nosocomial staphylococcal outbreaks
1Department of Microbiology, University Hospital, Queen's Medical Centre, Nottingham, England.
Abstract:
Staphylococcus aureus is the most frequently isolated single bacterial species from surgical wounds. During 1954-59, S. aureus phage 80/81 was responsible for more than 20% of staphylococcal epidemics in British hospitals. With the introduction of methicillin came satisfactory treatment of staphylococcal infection, though strains of methicillin-resistant S. aureus (MRSA) were quickly discovered. Outbreaks of MRSA infection usually start with the transfer or admission of either a patient or healthcare worker colonized or infected with MRSA from another hospital or the community. Long-stay patients act as reservoirs for MRSA which spread via several modes of transmission. Hospital outbreaks of MRSA infection are difficult to control and may require stringent containment measures entailing considerable expense. Infection control is dependent on staff education programmes and surveillance. In the event of an MRSA epidemic, infection control staff may need to solicit the help of a team of trained specialists to implement intensive surveillance programmes, to identify and isolate MRSA carriers and eradicate the carriage of MRSA. Antibiotics are widely used for the prevention of infection, but control should be exercised as excessive antibiotic use has been identified as a risk factor for outbreaks of infection.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant threat in hospitals, spreading easily from patients and staff. Controlling MRSA outbreaks requires intensive surveillance, isolation of carriers, and careful antibiotic use.
Area of Science:
- Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Staphylococcus aureus is a common cause of surgical wound infections.
- The emergence of methicillin-resistant Staphylococcus aureus (MRSA) presents a significant treatment challenge.
- MRSA outbreaks in hospitals are difficult to control and costly.
Purpose of the Study:
- To highlight the epidemiology and control of MRSA in hospital settings.
- To emphasize the importance of infection control strategies against MRSA.
- To discuss the role of antibiotic use in MRSA outbreaks.
Main Methods:
- Review of historical data on Staphylococcus aureus and MRSA outbreaks.
- Discussion of transmission routes and reservoirs of MRSA within hospitals.
- Analysis of infection control measures and their effectiveness.
Main Results:
- MRSA outbreaks often originate from newly admitted patients or healthcare workers.
- Long-stay patients can serve as reservoirs for MRSA transmission.
- Effective control relies on staff education, surveillance, and carrier identification/eradication.
Conclusions:
- Hospital-acquired MRSA infections pose a persistent challenge requiring comprehensive control measures.
- Intensive surveillance and isolation are crucial during MRSA epidemics.
- Judicious antibiotic use is essential to prevent MRSA outbreaks, as overuse is a risk factor.