An Outbreak of MRSA colonisation in a Neonatal intensive care unit: use of a case control study to investigate and control it and lessons learned

We describe the investigation and management of an MRSA outbreak on a neonatal intensive care unit (NICU) and the lessons learnt.Study designOutbreak report and case-control study.Study setting and participants: The study was conducted in a 40-cot NICU in a tertiary referral hospital and included all infants colonised/infected with gentamicin-resistant MRSA.InterventionsStandard infection control measures including segregation of infants, barrier precautions, enhanced cleaning, assessment of staff practice including hand hygiene, and increased MRSA screening of infants were implemented. Continued MRSA acquisitions led to screening of all NICU staff. A case-control study was performed to assess staff contact with colonised babies and inform the management of the outbreak.ResultsEight infants were colonised with MRSA (spa type t2068), one of whom subsequently developed an MRSA bacteraemia. MRSA colonisation was significantly associated with lower gestational age; lower birthweight and with being a twin. Three nurses were MRSA colonised but only nurse 45 was colonised with MRSA spa type t2068. Multivariable logistic regression analysis identified being cared for by nurse 45 as an independent risk factor for MRSA colonisation.InterpretationLack of accurate recording of which nurses looked after which infants (and when) made identification of the risk posed by being cared for by particular nurses difficult. If this had been clearer, it may have enabled earlier identification of th...
Source: Journal of Hospital Infection - Category: Infectious Diseases Source Type: research

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CONCLUSIONS: ICPBP2a Culture Colony Test (AlereTM) is fast, efficient and economical technique for detection of penicillin binding protein 2a (PBP2a) from isolates. This assay is a useful tool for the management of hospital outbreaks. PMID: 31293115 [PubMed - as supplied by publisher]
Source: Revista Espanola de Quimioterapia - Category: Drugs & Pharmacology Authors: Tags: Rev Esp Quimioter Source Type: research
The first Canadian outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was identified in 2004 in Calgary, Alberta. Using a novel model of MRSA population-based surveillance, soc...
Source: BMC Public Health - Category: Consumer Health News Authors: Tags: Research article Source Type: research
ConclusionsOnly the network animation over time revealed possible transmission of MRSA through the network, rather than attributes measured in the traditional case control study.
Source: American Journal of Infection Control - Category: Infectious Diseases Source Type: research
ConclusionsLack of accurate recording of which nurses looked after which infants (and when) made identification of the risk posed by being cared for by particular nurses difficult. If this had been clearer, it may have enabled earlier identification of the colonized nurse, avoiding subsequent cases. This study highlights the benefit of using a case–control study, which showed that most nurses had no association with colonized infants.
Source: Journal of Hospital Infection - Category: Infectious Diseases Source Type: research
CONCLUSIONSRectal and groin surveillance for CRE, ESBL, VRE and MRSA for high risk patients is a very effective method of establishing MDRO colonization. Identifying the colonization status of CCU patients is an essential step in hospital associated infection prevention and outbreak investigations.
Source: American Journal of Infection Control - Category: Infectious Diseases Source Type: research
There is growing evidence for the value of bacterial whole-genome sequencing in hospital outbreak investigations. Our aim was to develop methods that support efficient and accurate low-throughput clinical sequencing of methicillin-resistant Staphylococcus aureus (MRSA) isolates. Using a test panel of 25 MRSA isolates previously associated with outbreak investigations, we devised modifications to library preparation that reduced the processing time by 1 hour. We determined the maximum number of isolates that could be sequenced per run using an Illumina MiniSeq platform and a 13-hour (overnight) run time, which equated to 21...
Source: Journal of Clinical Microbiology - Category: Microbiology Authors: Tags: Bacteriology Source Type: research
us Andreas Seidler People working in health care services have an increased risk of being infected with methicillin-resistant Staphylococcus aureus (MRSA), though little is known about the prevalence in rehabilitation centers. This cross-sectional study investigated the MRSA prevalence in employees from different rehabilitation centers and aimed to identify risk factors for MRSA transmission. We invited all staff (i.e., with and without patient contact from 22 participating rehabilitation centers; n = 2499) to participate. Study participation included a questionnaire on personal characteristics, lifestyle, personal a...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Conclusions: We present the most detailed genomic analysis of MRSA isolated in Sri Lanka to date. The analysis identified a PVL-positive ST5-MRSA-IVc that is prevalent among MRSA causing clinical infections in Sri Lanka. Furthermore, this clone was also found among isolates from the United Kingdom and Australia. Introduction Worldwide, Staphylococcus aureus is the primary causative agent of community-acquired skin and soft tissue infections (SSTI) and is an important cause of hospital-associated invasive infections including bacteremia, pneumonia and endocarditis (Bell et al., 2002; David and Daum, 2010). Panton-Va...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Julija Armalytė1, Jūratė Skerniškytė1, Elena Bakienė1, Renatas Krasauskas1, Rita Šiugždinienė2, Violeta Kareivienė2, Sigita Kerzienė2, Irena Klimienė2, Edita Sužiedėlienė1 and Modestas Ružauskas2* 1Life Sciences Center, Institute of Biosciences, Vilnius University, Vilnius, Lithuania 2Institute of Microbiology and Virology, Lithuanian University of Health Sciences, Kaunas, Lithuania Soil is one of the biggest reservoirs of microbial diversity, yet the processes that define the community dynamics are not fully understood. Apart from soil management being vital for agricultural purposes...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
In this study, the multivariate linear mixed model (LMM) was used to calculate the P-value to determine interesting SNPs at each time point using GEMMA software v0.97 (Zhou and Stephens, 2014). Growth data from both untreated and vancomycin-treated group formed the bivariate phenotype, which differs hugely from the univariate phenotype. Therefore, LMM developed for univariate phenotype cannot be applied to analyze correlated phenotype directly; methods allowing LMM algorithm specific to multivariate and correlated phenotype [multivariate LMMs (mvLMMs)] are in urgent need. GEMMA software could extend a standard LMM to mvLMM...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
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