The epidemiology of methicillin-resistant Staphylococcus aureus on a burn trauma unit

Marin Schweizer; Melissa Ward; Sandra Cobb; Jennifer McDanel; Laurie Leder; Lucy Wibbenmeyer; Barbara Latenser; Daniel Diekema; Loreen Herwaldt

doi:10.1086/668032

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The epidemiology of methicillin-resistant Staphylococcus aureus on a burn trauma unit

Journal article

Peer reviewed

The epidemiology of methicillin-resistant Staphylococcus aureus on a burn trauma unit

Marin Schweizer, Melissa Ward, Sandra Cobb, Jennifer McDanel, Laurie Leder, Lucy Wibbenmeyer, Barbara Latenser, Daniel Diekema and Loreen Herwaldt

Infection control and hospital epidemiology, Vol.33(11), pp.1118-1125

11/2012

DOI: 10.1086/668032

PMCID: PMC4447144

PMID: 23041810

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Abstract

We assessed the frequency and relatedness of methicillin-resistant Staphylococcus aureus (MRSA) isolates to determine whether healthcare workers, the environment, or admitted patients could be a reservoir for MRSA on a burn trauma unit (BTU). We also assessed risk factors for MRSA colonization among BTU patients. Prospective cohort study and surveillance for MRSA carriage. BTU of a Midwestern academic medical center. Patients admitted to a BTU from February 2009 through January 2010 and healthcare workers on this unit during the same time period. Samples for MRSA culture were collected on admission from the nares and wounds of all BTU patients. We also had collected culture samples from the throat, axilla, antecubital fossa, groin, and perianal area of 12 patients per month. Samples collected from healthcare workers' nares and from environmental sites were cultured quarterly. MRSA isolates were typed by pulsed-field gel electrophoresis. Of 144 patients, 24 (17%) carried MRSA in their nares on admission. Male sex (odds ratio [OR], 5.51; 95% confidence interval [95% CI], 1.25-24.30), admission for necrotizing fasciitis (OR, 7.66; 95% CI, 1.64-35.81), and MRSA colonization of a site other than the nares (OR, 23.40; 95% CI, 6.93-79.01) were independent predictors of MRSA nasal carriage. Cultures of samples collected from 4 healthcare workers and 4 environmental cultures had positive results. Two patients were colonized with strains that were indistinguishable from strains collected from a healthcare worker or the environment. Patients were a major reservoir for MRSA. Infection control efforts should focus on preventing transmission of MRSA from patients who are MRSA carriers to other patients on the unit.

Prospective Studies

Humans

Middle Aged

Carrier State - microbiology

Male

Academic Medical Centers

Methicillin-Resistant Staphylococcus aureus - growth & development

Staphylococcal Infections - epidemiology

Disease Reservoirs - microbiology

Health Personnel

Midwestern United States - epidemiology

Adult

Female

Burn Units

Methicillin-Resistant Staphylococcus aureus - isolation & purification

Population Surveillance

Details

Title: Subtitle: The epidemiology of methicillin-resistant Staphylococcus aureus on a burn trauma unit
Creators: Marin Schweizer - University of Iowa Carver College of Medicine, Department of Internal Medicine, Iowa City, Iowa, USA. marin-schweizer@uiowa.edu
Melissa Ward
Sandra Cobb
Jennifer McDanel
Laurie Leder
Lucy Wibbenmeyer
Barbara Latenser
Daniel Diekema
Loreen Herwaldt
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology, Vol.33(11), pp.1118-1125
DOI: 10.1086/668032
PMID: 23041810
PMCID: PMC4447144
NLM abbreviation: Infect Control Hosp Epidemiol
ISSN: 0899-823X
eISSN: 1559-6834
Publisher: United States
Grant note: R18 CI000583 / NCPDCID CDC HHS KL2 RR024980 / NCRR NIH HHS 5R18CI000583 / NCPDCID CDC HHS 3KL2 RR024980-04S1 / NCRR NIH HHS
Language: English
Date published: 11/2012
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Surgery; Injury Prevention Research Center; General Internal Medicine; Internal Medicine
Record Identifier: 9983986376802771

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