Bächli, Magi; Sommerstein, Rami; Casanova, Carlo; Droz, Sara; Küffer, Marianne; Marschall, Jonas (2022). Meticillin-resistant Staphylococcus aureus Contact Screening Strategy in a Low Prevalence Setting; a Nested Case-Control Study. Infection prevention in practice, 4(2), p. 100211. Elsevier 10.1016/j.infpip.2022.100211
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Background
The optimal screening strategy in hospitals to identify secondary cases after contact with a meticillin-resistant Staphylococcus aureus (MRSA) index patient in a low prevalence setting is not well defined. We aimed at identifying factors associated with documented MRSA transmissions.
Method
Single center, retrospective, nested case-control study. We evaluated the screening strategy in our 950 bed tertiary care hospital from 2008 - 2014. Room and ward contacts of MRSA index patients present at time of MRSA identification were screened. We compared characteristics of Staphylococcus aureus Protein A (spa)-type matched contact patients (cases) to negative or spa-type mismatched contact patients (controls).
Results
Among 270,000 inpatients from 2008 - 2014, 215 MRSA screenings yielded 3013 contact patients, and 6 (0.2%) spa-type matched pairs. We included 225 controls for the nested case-control study. The contact type for the cases was more frequently "same room" and less frequently "same ward" compared with the controls (P = 0.001). Also, exposure time was longer for cases (median of 6 days [IQR 3-9]) than for controls (1 day [0-3], P=0.016).
Conclusion
The extensive MRSA screening strategy revealed only few index/contact matches based on spa-typing. Prolonged exposure time and a shared room were significantly associated with MRSA transmission. A targeted screening strategy may be more useful in a low prevalence setting than screening entire wards.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology 04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > General Bacteriology |
UniBE Contributor: |
Bächli, Magi, Sommerstein, Rami, Casanova, Carlo, Droz, Sara Christine, Küffer, Marianne, Marschall, Jonas |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2590-0889 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
28 Mar 2022 08:04 |
Last Modified: |
05 Dec 2022 16:17 |
Publisher DOI: |
10.1016/j.infpip.2022.100211 |
PubMed ID: |
35330753 |
Uncontrolled Keywords: |
Contact patient MRSA Nosocomial transmission Screening strategy Spa type |
BORIS DOI: |
10.48350/168140 |
URI: |
https://boris.unibe.ch/id/eprint/168140 |
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