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Origin and transmission of methicillin-resistant Staphylococcus aureus in an endemic situation: differences between
A Hoefnagels-Schuermans1, A Borremans, W Peetermans
1Department of Microbiology and Immunology, Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.
Abstract:
Imported vs. hospital-acquisition of MRSA was assessed in > 6000 patients at a large tertiary care teaching hospital. About five percent (5.1%) of patients carried MRSA on admission, mostly without clinical symptoms; the highest percentage (11.6%) being in geriatric patients. Hospital-acquisition of MRSA occurred in 1.7% of patients and was particularly high in intensive-care units (5.2%). Phenotype and genotype analysis of 158 MRSA strains isolated from 61 patients revealed a cluster of closely related strains in the hospital-acquired MRSA infections and the close relationship of this cluster to the regional epidemic MRSA strain. The MRSA strains imported by geriatric patients were genetically different, did not spread between geriatric patients and were only a minor source of nosocomial infection.
Insights
Most patients admitted to hospitals do not carry Methicillin-resistant Staphylococcus aureus (MRSA). However, MRSA can be acquired during hospitalization, especially in intensive care units, and is linked to regional epidemic strains.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
- Understanding the sources and transmission patterns of MRSA is crucial for effective infection control.
- Geriatric patients represent a vulnerable population for healthcare-associated infections.
Purpose of the Study:
- To differentiate between imported and hospital-acquired MRSA in a large patient cohort.
- To investigate the genetic relatedness of MRSA strains causing infections.
- To assess the prevalence and characteristics of MRSA colonization and infection in different patient groups.
Main Methods:
- Retrospective analysis of >6000 patient records at a tertiary care teaching hospital.
- Phenotypic and genotypic analysis of 158 MRSA strains from 61 patients.
- Comparison of MRSA strains from imported (admission) and hospital-acquired infections.
Main Results:
- 5.1% of patients were colonized with MRSA on admission, highest in geriatric patients (11.6%).
- 1.7% of patients acquired MRSA during hospitalization, with a higher rate (5.2%) in intensive care units.
- Hospital-acquired MRSA strains were genetically related to each other and to a regional epidemic strain.
- MRSA strains imported by geriatric patients were genetically distinct and did not contribute significantly to nosocomial spread.
Conclusions:
- Hospital acquisition of MRSA is a significant concern, particularly in ICUs.
- A specific cluster of MRSA strains is responsible for hospital-acquired infections and is linked to regional epidemics.
- MRSA strains carried by geriatric patients are generally different and pose a lower risk for nosocomial transmission.