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Prevalence of nasal methicillin-resistant Staphylococcus aureus colonization in healthcare workers in a Western Australian acute care hospital

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Abstract

Due to a longstanding comprehensive “search and destroy policy”, methicillin-resistant Staphylococcus aureus (MRSA) is not endemic in Western Australian (WA) acute care hospitals. As the prevalence of MRSA in the community has increased, healthcare workers (HCW) are at risk of importing MRSA into hospitals. We aimed to determine the prevalence of and risk factors for nasal MRSA colonization in our HCW population. A period prevalence study was conducted at an 850-bed tertiary hospital. Basic demographics and a nasal swab were obtained. A total of 1,542 HCWs employed in our centre were screened for MRSA, of whom 3.4% (n = 52) were colonized. MRSA colonization was more common in patient care assistants (6.8%) and nurses (5.2%) than in allied health professionals (1.7%) and doctors (0.7%) (p < 0.01). Working in “high-risk” wards that cared for MRSA colonized/infected patients was the strongest risk factor for HCW MRSA colonization (p < 0.001). ST1-IV and ST78-IV (the most common community clones in the region) were the most frequently identified clones. In conclusion, MRSA colonization of HCWs occurs primarily in HCWs caring for patients colonized or infected with MRSA. Surveillance screening of HCWs should be regularly performed on wards with patients with high MRSA colonization prevalence to prevent further spread in the hospital.

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References

  1. Pearman JW, Christiansen KJ, Annear DI, Goodwin CS, Metcalf C, Donovan FP, Macey KL, Bassette LD, Powell IM, Green JM et al (1985) Control of methicillin-resistant Staphylococcus aureus (MRSA) in an Australian metropolitan teaching hospital complex. Med J Aust 142(2):103–108

    PubMed  CAS  Google Scholar 

  2. Boyce JM, Cookson B, Christiansen K, Hori S, Vuopio-Varkila J, Kocagoz S, Oztop AY, Vandenbroucke-Grauls CM, Harbarth S, Pittet D (2005) Methicillin-resistant Staphylococcus aureus. Lancet Infect Dis 5(10):653–663

    Article  PubMed  Google Scholar 

  3. Nimmo GR, Coombs GW, Pearson JC, O'Brien FG, Christiansen KJ, Turnidge JD, Gosbell IB, Collignon P, McLaws ML (2006) Methicillin-resistant Staphylococcus aureus in the Australian community: an evolving epidemic. Med J Aust 184(8):384–388

    PubMed  Google Scholar 

  4. Dailey L, Coombs GW, O'Brien FG, Pearman JW, Christiansen K, Grubb WB, Riley TV (2005) Methicillin-resistant Staphylococcus aureus, Western Australia. Emerg Infect Dis 11(10):1584–1590

    Article  PubMed  Google Scholar 

  5. Udo EE, Pearman JW, Grubb WB (1993) Genetic analysis of community isolates of methicillin-resistant Staphylococcus aureus in Western Australia. J Hosp Infect 25(2):97–108

    Article  PubMed  CAS  Google Scholar 

  6. Coombs GW, Pearson JC, Christiansen K (2009) Western Australian antibiotic-resistant gram-positive bacteria epidemiology and typing report (MRSA and VRE), Perth. http://www.public.health.wa.gov.au/cproot/2491/2/HD%20REPORT%20December%202008.pdf. Cited 24 May 2010

  7. Coombs GW, Pearson JC, O'Brien FG, Murray RJ, Grubb WB, Christiansen KJ (2006) Methicillin-resistant Staphylococcus aureus clones, Western Australia. Emerg Infect Dis 12(2):241–247

    Article  PubMed  Google Scholar 

  8. Coombs GW, Pearson J, Peterson A, Christiansen K (2010) Long term care facility patients and healthcare workers are a reservoir of EMRSA-15 in Western Australia. Interscience Conference on Antimicrobial Agents and Chemotherapy, Boston, Massachusetts, USA

  9. Vos MC, Behrendt MD, Melles DC, Mollema FP, de Groot W, Parlevliet G, Ott A, Horst-Kreft D, van Belkum A, Verbrugh HA (2009) 5 years of experience implementing a methicillin-resistant Staphylococcus aureus search and destroy policy at the largest university medical center in the Netherlands. Infect Control Hosp Epidemiol 30(10):977–984

    Article  PubMed  Google Scholar 

  10. Amorim ML, Vasconcelos C, Oliveira DC, Azevedo A, Calado E, Faria NA, Pereira M, Castro AP, Moreira A, Aires E, Cabeda JM, Ramos MH, Amorim JM, de Lencastre H (2009) Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization among patients and healthcare workers in a Portuguese hospital: a pre-intervention study toward the control of MRSA. Microb Drug Resist 15(1):19–26

    Google Scholar 

  11. Elie-Turenne MC, Fernandes H, Mediavilla JR, Rosenthal M, Mathema B, Singh A, Cohen TR, Pawar KA, Shahidi H, Kreiswirth BN, Deitch EA (2010) Prevalence and characteristics of Staphylococcus aureus colonization among healthcare professionals in an urban teaching hospital. Infect Control Hosp Epidemiol 31(6):574–580

    Article  PubMed  Google Scholar 

  12. Saxena S, Goyal R, Das S, Mathur M, Talwar V (2002) Prevalence of methicillin-resistant Staphylococcus aureus colonization among healthcare workers and healthy community residents. J Health Popul Nutr 20(3):279–280

    PubMed  CAS  Google Scholar 

  13. Coombs GW, Van Gessel H, Pearson JC, Godsell MR, O'Brien FG, Christiansen KJ (2007) Controlling a multicenter outbreak involving the New York/Japan methicillin-resistant Staphylococcus aureus clone. Infect Control Hosp Epidemiol 28(7):845–852

    Article  PubMed  CAS  Google Scholar 

  14. Vonberg RP, Stamm-Balderjahn S, Hansen S, Zuschneid I, Ruden H, Behnke M, Gastmeier P (2006) How often do asymptomatic healthcare workers cause methicillin-resistant Staphylococcus aureus outbreaks? A systematic evaluation. Infect Control Hosp Epidemiol 27(10):1123–1127

    Article  PubMed  Google Scholar 

  15. Robinson JO, Pearson JC, Christiansen KJ, Coombs GW, Murray RJ (2008) Community-associated versus healthcare-associated methicillin-resistant Staphylococcus aureus bacteraemia: a 10-year retrospective review. Eur J Clin Microbiol Infect Dis 28(4):353–361

    Google Scholar 

  16. Costa AM, Kay I, Palladino S (2005) Rapid detection of mecA and nuc genes in staphylococci by real-time multiplex polymerase chain reaction. Diagn Microbiol Infect Dis 51(1):13–17

    Article  PubMed  CAS  Google Scholar 

  17. Coombs GW, Monecke S, Ehricht R, Slickers P, Pearson JC, Tan HL, Christiansen KJ, O'Brien FG (2010) Differentiation of clonal complex 59 community-associated methicillin-resistant Staphylococcus aureus in Western Australia. Antimicrob Agents Chemother 54(5):1914–1921

    Article  PubMed  CAS  Google Scholar 

  18. O'Brien FG, Udo EE, Grubb WB (2006) Contour-clamped homogeneous electric field electrophoresis of Staphylococcus aureus. Nat Protoc 1(6):3028–3033

    Article  PubMed  Google Scholar 

  19. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, Swaminathan B (1995) Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33(9):2233–2239

    PubMed  CAS  Google Scholar 

  20. Enright MC, Day NP, Davies CE, Peacock SJ, Spratt BG (2000) Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol 38(3):1008–1015

    PubMed  CAS  Google Scholar 

  21. Albrich WC, Harbarth S (2008) Health-care workers: source, vector, or victim of MRSA? Lancet Infect Dis 8(5):289–301

    Article  PubMed  Google Scholar 

  22. Eveillard M, Martin Y, Hidri N, Boussougant Y, Joly-Guillou ML (2004) Carriage of methicillin-resistant Staphylococcus aureus among hospital employees: prevalence, duration, and transmission to households. Infect Control Hosp Epidemiol 25(2):114–120

    Article  PubMed  Google Scholar 

  23. Nimmo GR, Pearson JC, Collignon PJ, Christiansen KJ, Coombs GW, Bell JM, McLaws ML (2007) Prevalence of MRSA among Staphylococcus aureus isolated from hospital inpatients, 2005: report from the Australian Group for Antimicrobial Resistance. Commun Dis Intell 31(3):288–296

    PubMed  Google Scholar 

  24. Duggan JM, Hensley S, Khuder S, Papadimos TJ, Jacobs L (2008) Inverse correlation between level of professional education and rate of handwashing compliance in a teaching hospital. Infect Control Hosp Epidemiol 29(6):534–538

    Article  PubMed  Google Scholar 

  25. Rioux C, Armand-Lefevre L, Guerinot W, Andremont A, Lucet JC (2007) Acquisition of methicillin-resistant Staphylococcus aureus in the acute care setting: incidence and risk factors. Infect Control Hosp Epidemiol 28(6):733–736

    Article  PubMed  Google Scholar 

  26. Cookson B, Peters B, Webster M, Phillips I, Rahman M, Noble W (1989) Staff carriage of epidemic methicillin-resistant Staphylococcus aureus. J Clin Microbiol 27(7):1471–1476

    PubMed  CAS  Google Scholar 

  27. Baker SE, Brecher SM, Robillard E, Strymish J, Lawler E, Gupta K (2010) Extranasal methicillin-resistant Staphylococcus aureus colonization at admission to an acute care Veterans Affairs hospital. Infect Control Hosp Epidemiol 31(1):42–46

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors want to thank all the healthcare workers of Royal Perth Hospital who participated in this study.

This study was supported by the Department of Microbiology and Infectious Diseases, Royal Perth Hospital.

Conflict of interest

All authors report no conflict of interest.

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Authors and Affiliations

  1. Department of Medical Microbiology & Infectious Diseases, Erasmus Medical Centre, Rotterdam, The Netherlands

    P. E. B. Verwer, H. A. Verbrugh & J. L. Nouwen

  2. Departments of Microbiology and Infectious Diseases and PathWest Laboratory Medicine WA, Royal Perth Hospital, Perth, Australia

    P. E. B. Verwer, J. O. Robinson, G. W. Coombs, T. Wijesuriya & K. J. Christiansen

  3. Australian Collaborating Centre for Enterococcus and Staphylococcus Species Typing and Research, PathWest Laboratory Medicine WA and Curtin University of Technology, Bentley, Australia

    J. O. Robinson, G. W. Coombs & K. J. Christiansen

  4. Department of Infectious Diseases, Sir Charles Gairdner Hospital, Perth, Australia

    R. J. Murray & T. Riley

  5. Department of Microbiology, PathWest Laboratory Medicine – WA, Queen Elizabeth II Medical Centre, Perth, Australia

    R. J. Murray & T. Riley

  6. Departments of Microbiology and Immunology, University of Western Australia, Perth, Australia

    T. Riley

Authors
  1. P. E. B. Verwer
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  2. J. O. Robinson
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  3. G. W. Coombs
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  4. T. Wijesuriya
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  6. H. A. Verbrugh
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  7. T. Riley
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  8. J. L. Nouwen
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  9. K. J. Christiansen
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Correspondence to J. O. Robinson.

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Verwer, P.E.B., Robinson, J.O., Coombs, G.W. et al. Prevalence of nasal methicillin-resistant Staphylococcus aureus colonization in healthcare workers in a Western Australian acute care hospital. Eur J Clin Microbiol Infect Dis 31, 1067–1072 (2012). https://doi.org/10.1007/s10096-011-1408-6

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  • DOI: https://doi.org/10.1007/s10096-011-1408-6

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