Gastrointestinal colonization of meticillin-resistant Staphylococcus aureus : an unrecognized burden upon hospital infection control
Copyright © 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Meticillin-resistant Staphylococcus aureus (MRSA) has become endemic in many healthcare settings.
AIM: To analyse the incidence, risk factors, outcomes, and genomic relatedness of patients with newly diagnosed gastrointestinal colonization of MRSA.
METHODS: Epidemiology and genetic analysis by whole-genome sequencing (WGS) in a hospital network in Hong Kong.
FINDINGS: Between October 1st, 2015 and December 31st, 2018, a total of 919 (2.7%) of 34,667 patients had newly diagnosed gastrointestinal MRSA colonization by admission screening. The incidence was 0.67 ± 0.32 per 1000 patient-days per quarter. Including patients with gastrointestinal MRSA colonization, the overall burden of MRSA increased by 59.2%, with an addition of 4727 MRSA patient-days during the study period. Patients referred from residential care home for the elderly, with history of hospitalization in the past six months, and consumption of fluoroquinolones, cephalosporins, and proton-pump inhibitors in the preceding six months were found to be independent risk factors by multivariate analysis in the case-control analysis. The median survival of cases was significantly shorter than that of controls (860 vs 1507 days, P < 0.001). Of 919 patients, 127 (13.8%) developed symptomatic MRSA infection in a median of 112 days. Of 19 patients with paired MRSA faecal and blood culture isolates subjected to WGS, clonality was found in 16 (84.2%) pairs of MRSA isolates. MRSA ST45 constituted 44.7% (17/38) of MRSA isolates.
CONCLUSION: Gastrointestinal MRSA colonization may contribute to adverse clinical outcomes and pose an unrecognized burden upon hospital infection control.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:121 |
|---|---|
| Enthalten in: |
The Journal of hospital infection - 121(2022) vom: 01. März, Seite 65-74 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Wong, S-C [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Gastrointestinal colonization |
|---|
| Anmerkungen: |
Date Completed 07.03.2022 Date Revised 07.03.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jhin.2021.12.016 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM334898390 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM334898390 | ||
| 003 | DE-627 | ||
| 005 | 20231225224702.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jhin.2021.12.016 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1116.xml |
| 035 | |a (DE-627)NLM334898390 | ||
| 035 | |a (NLM)34953945 | ||
| 035 | |a (PII)S0195-6701(21)00457-6 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Wong, S-C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Gastrointestinal colonization of meticillin-resistant Staphylococcus aureus |b an unrecognized burden upon hospital infection control |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 07.03.2022 | ||
| 500 | |a Date Revised 07.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Meticillin-resistant Staphylococcus aureus (MRSA) has become endemic in many healthcare settings | ||
| 520 | |a AIM: To analyse the incidence, risk factors, outcomes, and genomic relatedness of patients with newly diagnosed gastrointestinal colonization of MRSA | ||
| 520 | |a METHODS: Epidemiology and genetic analysis by whole-genome sequencing (WGS) in a hospital network in Hong Kong | ||
| 520 | |a FINDINGS: Between October 1st, 2015 and December 31st, 2018, a total of 919 (2.7%) of 34,667 patients had newly diagnosed gastrointestinal MRSA colonization by admission screening. The incidence was 0.67 ± 0.32 per 1000 patient-days per quarter. Including patients with gastrointestinal MRSA colonization, the overall burden of MRSA increased by 59.2%, with an addition of 4727 MRSA patient-days during the study period. Patients referred from residential care home for the elderly, with history of hospitalization in the past six months, and consumption of fluoroquinolones, cephalosporins, and proton-pump inhibitors in the preceding six months were found to be independent risk factors by multivariate analysis in the case-control analysis. The median survival of cases was significantly shorter than that of controls (860 vs 1507 days, P < 0.001). Of 919 patients, 127 (13.8%) developed symptomatic MRSA infection in a median of 112 days. Of 19 patients with paired MRSA faecal and blood culture isolates subjected to WGS, clonality was found in 16 (84.2%) pairs of MRSA isolates. MRSA ST45 constituted 44.7% (17/38) of MRSA isolates | ||
| 520 | |a CONCLUSION: Gastrointestinal MRSA colonization may contribute to adverse clinical outcomes and pose an unrecognized burden upon hospital infection control | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Gastrointestinal colonization | |
| 650 | 4 | |a Infection control | |
| 650 | 4 | |a Meticillin-resistant Staphylococcus aureus | |
| 650 | 7 | |a Methicillin |2 NLM | |
| 650 | 7 | |a Q91FH1328A |2 NLM | |
| 700 | 1 | |a Chen, J H-K |e verfasserin |4 aut | |
| 700 | 1 | |a So, S Y-C |e verfasserin |4 aut | |
| 700 | 1 | |a Ho, P-L |e verfasserin |4 aut | |
| 700 | 1 | |a Yuen, K-Y |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, V C-C |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of hospital infection |d 1993 |g 121(2022) vom: 01. März, Seite 65-74 |w (DE-627)NLM012638692 |x 1532-2939 |7 nnns |
| 773 | 1 | 8 | |g volume:121 |g year:2022 |g day:01 |g month:03 |g pages:65-74 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jhin.2021.12.016 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 121 |j 2022 |b 01 |c 03 |h 65-74 | ||