Gastrointestinal colonization of meticillin-resistant Staphylococcus aureus: an unrecognized burden upon hospital infection control.
J Hosp Infect
; 121: 65-74, 2022 Mar.
Article
en En
| MEDLINE
| ID: mdl-34953945
ABSTRACT
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infecciones Estafilocócicas
/
Infección Hospitalaria
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Staphylococcus aureus Resistente a Meticilina
Tipo de estudio:
Etiology_studies
/
Risk_factors_studies
Límite:
Aged
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Humans
Idioma:
En
Revista:
J Hosp Infect
Año:
2022
Tipo del documento:
Article
País de afiliación:
China
Pais de publicación:
ENGLAND
/
ESCOCIA
/
GB
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GREAT BRITAIN
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INGLATERRA
/
REINO UNIDO
/
SCOTLAND
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UK
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UNITED KINGDOM