ABSTRACT
Outbreaks of skin and soft tissue infections mediated by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) are being reported with increasing frequency among men who have sex with men (MSM). However, the potential role of asymptomatic colonization with this organism in perpetuating these infections is unclear. The purpose of this cross-sectional study was to determine the prevalence of colonization with CA-MRSA among a cohort of 500 MSM recruited from two inner city clinics in Toronto, Canada. Following the provision of informed consent, subjects completed a questionnaire capturing demographic and clinical variables, which may be associated with MRSA colonization. A nasal swab for MRSA was collected from each subject, and instructions were provided regarding the self-collection of a rectal swab. Cultured MRSA underwent pulsed-field gel electrophoresis and virulence testing for Panton-Valentine leukocidin gene expression. The prevalence of CA-MRSA colonization was 1.6% (95% CI: 0.5-2.6%).
Subject(s)
Carrier State/epidemiology , Homosexuality, Male , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcal Infections/epidemiology , Adult , Community-Acquired Infections/epidemiology , Cross-Sectional Studies , Data Interpretation, Statistical , Humans , Male , Middle Aged , Prevalence , Risk Factors , Staphylococcal Infections/microbiology , Surveys and QuestionnairesABSTRACT
Cross-contamination with laboratory control strains of vancomycin-resistant Enterococcus faecalis was documented in 15 clinical specimens from nine clinical microbiology laboratories in Ontario, Canada. Laboratories should be alert to the possibility of contamination of specimens with vancomycin-resistant enterococci from the laboratory environment. Molecular typing of strains may assist in elucidating the source of such contamination.
Subject(s)
Enterococcus faecalis/drug effects , Enterococcus faecalis/isolation & purification , Equipment Contamination , Laboratories/standards , DNA, Bacterial/genetics , DNA, Bacterial/isolation & purification , Electrophoresis, Gel, Pulsed-Field , Enterococcus faecalis/classification , Enterococcus faecalis/genetics , Enterococcus faecium/classification , Enterococcus faecium/drug effects , Enterococcus faecium/genetics , Enterococcus faecium/isolation & purification , Environmental Microbiology , Genotype , Humans , Ontario , Quality Control , Vancomycin Resistance/geneticsABSTRACT
We compared our current screening strategy for vancomycin-resistant Enterococcus (VRE) with a focused strategy that screens all stool samples sent for Clostridium difficile toxin assay but limits rectal swab screening to wards with new VRE cases detected via C. difficile samples. The proposed strategy detects 72.7% of new VRE cases, with substantial cost savings.