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Antimicrobial Resistance & Infection Control
Published in: Antimicrobial Resistance & Infection Control 1/2020

Open Access 01-12-2020 | Clostridioides Difficile | Review

One Health in hospitals: how understanding the dynamics of people, animals, and the hospital built-environment can be used to better inform interventions for antimicrobial-resistant gram-positive infections

Authors: Kathryn R. Dalton, Clare Rock, Karen C. Carroll, Meghan F. Davis

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2020

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Abstract

Despite improvements in hospital infection prevention and control, healthcare associated infections (HAIs) remain a challenge with significant patient morbidity, mortality, and cost for the healthcare system. In this review, we use a One Health framework (human, animal, and environmental health) to explain the epidemiology, demonstrate key knowledge gaps in infection prevention policy, and explore improvements to control Gram-positive pathogens in the healthcare environment. We discuss patient and healthcare worker interactions with the hospital environment that can lead to transmission of the most common Gram-positive hospital pathogens – methicillin-resistant Staphylococcus aureus, Clostridioides (Clostridium) difficile, and vancomycin-resistant Enterococcus – and detail interventions that target these two One Health domains. We discuss the role of animals in the healthcare settings, knowledge gaps regarding their role in pathogen transmission, and the absence of infection risk mitigation strategies targeting animals. We advocate for novel infection prevention and control programs, founded on the pillars of One Health, to reduce Gram-positive hospital-associated pathogen transmission.
Literature
1.
Destoumieux-Garzon D, Mavingui P, Boetsch G, Boissier J, Darriet F, Duboz P, et al. The one health concept: 10 years old and a long road ahead. Front Vet Sci. 2018;5:14.PubMedPubMedCentralCrossRef
2.
Okello AL, Bardosh K, Smith J, Welburn SC. One health: past successes and future challenges in three African contexts. PLoS Negl Trop Dis. 2014;8(5):e2884.PubMedPubMedCentralCrossRef
3.
Dulon M, Peters C, Schablon A, Nienhaus A. MRSA carriage among healthcare workers in non-outbreak settings in Europe and the United States: a systematic review. BMC Infect Dis. 2014;14:363.PubMedPubMedCentralCrossRef
4.
Xue Y, Gyi AA. Predictive risk factors for methicillin-resistant Staphylococcus aureus (MRSA) colonisation among adults in acute care settings: a systematic review. JBI Libr Syst Rev. 2012;10(54):3487–560.PubMedCrossRef
5.
Patel PK, Mantey J, Mody L. Patient hand colonization with MDROs is associated with environmental contamination in post-acute care. Infect Control Hosp Epidemiol. 2017;38(9):1110–3.PubMedPubMedCentralCrossRef
6.
Hamilton WJ, Ryder DJ, Cooper HP, Williams DM, Weinberg AD. Environmental health: a survey of Texas primary care physicians. Tex Med. 2005;101(10):62–70.PubMed
7.
Allen HA. Characterizing zoonotic disease detection in the United States: who detects zoonotic disease outbreaks & how fast are they detected? J Infect Public Health. 2015;8(2):194–201.PubMedCrossRef
8.
9.
Beard-Pegler MA, Stubbs E, Vickery AM. Observations on the resistance to drying of staphylococcal strains. J Med Microbiol. 1988;26(4):251–5.PubMedCrossRef
10.
Barbut F. How to eradicate Clostridium difficile from the environment. J Hosp Infect. 2015;89(4):287–95.PubMedCrossRef
11.
Centers For Disease Control and Prevention. Methicillin-Resistant Staphylococcus aureus: Preventing Infections in Healthcare [Internet]. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP). 2019 [cited 2019 Jul 25]. Available from: https://​www.​cdc.​gov/​mrsa/​healthcare/​inpatient.​html.
12.
Evans ME, Kralovic SM, Simbartl LA, Jain R, Roselle GA. Eight years of decreased methicillin-resistant Staphylococcus aureus health care-associated infections associated with a veterans affairs prevention initiative. Am J Infect Control. 2017;45(1):13–6.PubMedCrossRef
13.
Larsen J, Petersen A, Sorum M, Stegger M, van Alphen L, Valentiner-Branth P, et al. Meticillin-resistant Staphylococcus aureus CC398 is an increasing cause of disease in people with no livestock contact in Denmark, 1999 to 2011. Euro Surveill Bull Eur sur les Mal Transm Eur Commun Dis Bull. 2015;20(37)..
14.
Price LB, Stegger M, Hasman H, Aziz M, Larsen J, Andersen PS, et al. Staphylococcus aureus CC398: host adaptation and emergence of methicillin resistance in livestock. MBio. 2012;3(1):e00305-11.
15.
Lawson PA, Citron DM, Tyrrell KL, Finegold SM. Reclassification of Clostridium difficile as Clostridioides difficile (Hall and O’Toole 1935) Prevot 1938. Anaerobe. 2016;40:95–9.PubMedCrossRef
16.
McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66(7):e1–48.PubMedPubMedCentralCrossRef
17.
Dancer SJ. Controlling hospital-acquired infection: focus on the role of the environment and new Technologies for Decontamination. Clin Microbiol Rev. 2014;27(4):665–90.PubMedPubMedCentralCrossRef
18.
Dannenberg AL, Capon AG. Healthy Communities. In: Frumkin H, editor. Environmental Health: From Global to Local. 3rd ed. San Francisco: Jossey-Bass; 2106. p. 377–412.
19.
Mills G. Living Better in the built environment. Make sure the environment of care is both safe and comfortable for patients, visitors, and staff. Jt Comm Perspect. 2015;35(9):9–11.PubMed
20.
Rock C, Anderson M, Lewis S, Scheeler V, Nowakowski E, Hsu Y-J, et al. Comparison of nylon-flocked swab and cellulose sponge methods for carbapenem-resistant Enterobacteriaceae and gram-negative organism recovery from high-touch surfaces in patient rooms. Infect Control Hosp Epidemiol. 2018;39(10):1257–61.PubMedPubMedCentralCrossRef
21.
Anderson DJ, Chen LF, Weber DJ, Moehring RW, Lewis SS, Triplett PF, et al. Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study. Lancet (London, England). 2017;389(10071):805–14.CrossRef
22.
Rampling A, Wiseman S, Davis L, Hyett AP, Walbridge AN, Payne GC, et al. Evidence that hospital hygiene is important in the control of methicillin-resistant Staphylococcus aureus. J Hosp Infect. 2001;49(2):109–16.PubMedCrossRef
23.
O’Neill L, Park S-H, Rosinia F. The role of the built environment and private rooms for reducing central line-associated bloodstream infections. PLoS One. 2018;13(7).
24.
Hardy KJ, Oppenheim BA, Gossain S, Gao F, Hawkey PM. A study of the relationship between environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) and patients’ acquisition of MRSA. Infect Control Hosp Epidemiol. 2006;27(2):127–32.PubMedCrossRef
25.
Ray AJ, Hoyen CK, Taub TF, Eckstein EC, Donskey CJ. Nosocomial transmission of vancomycin-resistant enterococci from surfaces, vol. 287. United States: JAMA; 2002. p. 1400–1.
26.
Verity P, Wilcox MH, Fawley W, Parnell P. Prospective evaluation of environmental contamination by Clostridium difficile in isolation side rooms. J Hosp Infect. 2001;49(3):204–9.PubMedCrossRef
27.
Faires MC, Pearl DL, Berke O, Reid-Smith RJ, Weese JS. The identification and epidemiology of meticillin-resistant Staphylococcus aureus and Clostridium difficile in patient rooms and the ward environment. BMC Infect Dis. 2013;13:342.PubMedPubMedCentralCrossRef
28.
Boyce JM. Environmental contamination makes an important contribution to hospital infection. J Hosp Infect. 2007;65(Suppl 2):50–4.PubMedCrossRef
29.
Huang SS, Datta R, Platt R. Risk of acquiring antibiotic-resistant bacteria from prior room occupants. JAMA Intern Med. 2006;166(18):1945–51.CrossRef
30.
Shaughnessy MK, Micielli RL, DePestel DD, Arndt J, Strachan CL, Welch KB, et al. Evaluation of hospital room assignment and acquisition of Clostridium difficile infection. Infect Control Hosp Epidemiol. 2011;32(3):201–6.PubMedCrossRef
31.
Mitchell BG, Dancer SJ, Anderson M, Dehn E. Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis. J Hosp Infect. 2015;91(3):211–7.PubMedCrossRef
32.
Plipat N, Spicknall IH, Koopman JS, Eisenberg JNS. The dynamics of methicillin-resistant Staphylococcus aureus exposure in a hospital model and the potential for environmental intervention. BMC Infect Dis. 2013;13:595.PubMedPubMedCentralCrossRef
33.
Dettenkofer M, Wenzler S, Amthor S, Antes G, Motschall E, Daschner FD. Does disinfection of environmental surfaces influence nosocomial infection rates? A systematic review. Am J Infect Control. 2004;32(2):84–9.PubMedCrossRef
34.
Sitzlar B, Deshpande A, Fertelli D, Kundrapu S, Sethi AK, Donskey CJ. An environmental disinfection odyssey: evaluation of sequential interventions to improve disinfection of Clostridium difficile isolation rooms. Infect Control Hosp Epidemiol. 2013;34(5):459–65.PubMedCrossRef
35.
Manian FA, Griesnauer S, Bryant A. Implementation of hospital-wide enhanced terminal cleaning of targeted patient rooms and its impact on endemic Clostridium difficile infection rates. Am J Infect Control. 2013;41(6):537–41.PubMedCrossRef
36.
Passaretti CL, Otter JA, Reich NG, Myers J, Shepard J, Ross T, et al. An evaluation of environmental decontamination with hydrogen peroxide vapor for reducing the risk of patient acquisition of multidrug-resistant organisms. Clin Infect Dis. 2013;56(1):27–35.PubMedCrossRef
37.
Dancer SJ, White LF, Lamb J, Girvan EK, Robertson C. Measuring the effect of enhanced cleaning in a UK hospital: a prospective cross-over study. BMC Med. 2009;7:28.PubMedPubMedCentralCrossRef
38.
Hayden MK, Bonten MJM, Blom DW, Lyle EA, van de Vijver DAMC, Weinstein RA. Reduction in acquisition of vancomycin-resistant enterococcus after enforcement of routine environmental cleaning measures. Clin Infect Dis. 2006;42(11):1552–60.PubMedCrossRef
39.
Knelson LP, Williams DA, Gergen MF, Rutala WA, Weber DJ, Sexton DJ, et al. A comparison of environmental contamination by patients infected or colonized with methicillin-resistant Staphylococcus aureus or Vancomycin-resistant enterococci: a multicenter study. Infect Control Hosp Epidemiol. 2014;35(7):872–5.PubMedPubMedCentralCrossRef
40.
Lei H, Jones RM, Li Y. Exploring surface cleaning strategies in hospital to prevent contact transmission of methicillin-resistant Staphylococcus aureus. BMC Infect Dis. 2017;17:85.
41.
Weber DJ, Rutala WA, Miller MB, Huslage K, Sickbert-Bennett E. Role of hospital surfaces in the transmission of emerging health care-associated pathogens: norovirus, Clostridium difficile, and Acinetobacter species. Am J Infect Control. 2010;38(5 Suppl 1):S25–33.PubMedCrossRef
42.
Stiller A, Salm F, Bischoff P, Gastmeier P. Relationship between hospital ward design and healthcare-associated infection rates: a systematic review and meta-analysis. Antimicrob Resist Infect Control. 2016;5:51.PubMedPubMedCentralCrossRef
43.
Archibald LK, Manning ML, Bell LM, Banerjee S, Jarvis WR. Patient density, nurse-to-patient ratio and nosocomial infection risk in a pediatric cardiac intensive care unit. Pediatr Infect Dis J. 1997;16(11):1045–8.PubMedCrossRef
44.
Gohil SK, Datta R, Cao C, Phelan MJ, Nguyen V, Rowther AA, et al. Impact of hospital population case-mix, including poverty, on hospital all-cause and infection-related 30-day readmission rates. Clin Infect Dis. 2015;61(8):1235–43.PubMedPubMedCentralCrossRef
45.
Davis FM, Sutzko DC, Grey SF, Mansour MA, Jain KM, Nypaver TJ, et al. Predictors of surgical site infection after open lower extremity revascularization. J Vasc Surg. 2017;65(6):1769–1778.e3.PubMedCrossRef
46.
Sousa P, Uva AS, Serranheira F, Uva MS, Nunes C. Patient and hospital characteristics that influence incidence of adverse events in acute public hospitals in Portugal: a retrospective cohort study. Int J Qual Heal care J Int Soc Qual Heal Care. 2018;30(2):132–7.CrossRef
47.
Ray MJ, Lin MY, Weinstein RA, Trick WE. Spread of Carbapenem-resistant Enterobacteriaceae among Illinois healthcare facilities: the role of patient sharing. Clin Infect Dis. 2016;63(7):889–93.PubMedCrossRef
48.
Dickstein Y, Nir-Paz R, Pulcini C, Cookson B, Beovic B, Tacconelli E, et al. Staffing for infectious diseases, clinical microbiology and infection control in hospitals in 2015: results of an ESCMID member survey. Clin Microbiol Infect. 2016;22(9):812.e9–812.e17.CrossRef
49.
Donker T, Wallinga J, Slack R, Grundmann H. Hospital Networks and the Dispersal of Hospital-Acquired Pathogens by Patient Transfer. PLoS One. 2012;7(4).
50.
Gibbons CL, van Bunnik BAD, Blatchford O, Robertson C, Porphyre T, Imrie L, et al. Not just a matter of size: a hospital-level risk factor analysis of MRSA bacteraemia in Scotland. BMC Infect Dis. 2016;16:222.PubMedPubMedCentralCrossRef
51.
Hocquet D, Muller A, Bertrand X. What happens in hospitals does not stay in hospitals: antibiotic-resistant bacteria in hospital wastewater systems. J Hosp Infect. 2016;93(4):395–402.PubMedCrossRef
52.
Haun N, Hooper-lane C, Safdar N. Healthcare Personnel Attire and Devices as Fomites: A Systematic Review. Infect Control Hosp Epidemiol. 2016;37(11):1367-73.
53.
Centers for Disease Control and Prevention. Guidelines for Environmental Infection Control in Health-Care Facilities: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HIPAC). 2003.
54.
International Society for Infectious Disease. Guide to Infection Control in the Hospital. 2018.
55.
Gehanno JF, Louvel A, Nouvellon M, Caillard J-F, Pestel-Caron M. Aerial dispersal of meticillin-resistant Staphylococcus aureus in hospital rooms by infected or colonised patients. J Hosp Infect. 2009;71(3):256–62.PubMedCrossRef
56.
Roberts K, Smith CF, Snelling AM, Kerr KG, Banfield KR, Sleigh PA, et al. Aerial dissemination of Clostridium difficile spores. BMC Infect Dis. 2008;8:7.PubMedPubMedCentralCrossRef
57.
Best EL, Fawley WN, Parnell P, Wilcox MH. The potential for airborne dispersal of Clostridium difficile from symptomatic patients. Clin Infect Dis. 2010;50(11):1450–7.PubMedCrossRef
58.
Otto M. Coagulase-negative staphylococci as reservoirs of genes facilitating MRSA infection: staphylococcal commensal species such as Staphylococcus epidermidis are being recognized as important sources of genes promoting MRSA colonization and virulence. Bioessays. 2013;35(1):4–11.PubMedCrossRef
59.
Lax S, Gilbert JA. Hospital-associated microbiota and implications for nosocomial infections. Trends Mol Med. 2015;21(7):427–32.PubMedCrossRef
60.
Christoff AP, Sereia AFR, Hernandes C, de Oliveira LFV. Uncovering the hidden microbiota in hospital and built environments: new approaches and solutions. Exp Biol Med. 2019;244(6):534–42.CrossRef
61.
Brooks B, Firek BA, Miller CS, Sharon I, Thomas BC, Baker R, et al. Microbes in the neonatal intensive care unit resemble those found in the gut of premature infants. Microbiome. 2014;2(1):1.PubMedPubMedCentralCrossRef
62.
Yokoe DS, Classen D. Improving patient safety through infection control: a new healthcare imperative. Infect Control Hosp Epidemiol. 2008;29(Suppl 1):S3–11.PubMedCrossRef
63.
Chen LF, Knelson LP, Gergen MF, Better OM, Nicholson BP, Woods CW, et al. A prospective study of transmission of multidrug-resistant organisms ( MDROs ) between environmental sites and hospitalized patients — the TransFER study. Infect Control Hosp Epidemiol. 2019;40:47–52.PubMedCrossRef
64.
D’Agata EMC, Horn MA, Ruan S, Webb GF, Wares JR. Efficacy of infection control interventions in reducing the spread of multidrug-resistant organisms in the hospital setting. PLoS One. 2012;7(2):e30170.PubMedPubMedCentralCrossRef
65.
Bagger JP, Zindrou D, Taylor KM. Postoperative infection with meticillin-resistant Staphylococcus aureus and socioeconomic background. Lancet (London, England). 2004;363(9410):706–8.CrossRef
66.
David MZ, Daum RS. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev. 2010;23(3):616–87.PubMedPubMedCentralCrossRef
67.
Morin CA, Hadler JL. Population-based incidence and characteristics of community-onset Staphylococcus aureus infections with bacteremia in 4 metropolitan Connecticut areas, 1998. J Infect Dis. 2001;184(8):1029–34.PubMedCrossRef
68.
Klevens RM, Morrison MA, Nadle J, Petit S, Gershman K, Ray S, et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA. 2007;298(15):1763–71.PubMedCrossRef
69.
Sharland M, Gandra S, Huttner B, Moja L, Pulcini C, Zeng M, et al. Encouraging AWaRe-ness and discouraging inappropriate antibiotic use-the new 2019 essential medicines list becomes a global antibiotic stewardship tool. Lancet Infect Dis. 2019;19(12):1278–80.PubMedCrossRef
70.
Buehrle DJ, Shively NR, Wagener MM, Clancy CJ, Decker BK. Sustained Reductions in Overall and Unnecessary Antibiotic Prescribing at Primary Care Clinics in a Veterans Affairs Healthcare System Following a Multifaceted Stewardship Intervention. Clinical Infectious Diseases. 2019. ciz1180.
71.
Ray MJ, Tallman GB, Bearden DT, Elman MR, McGregor JC. Antibiotic prescribing without documented indication in ambulatory care clinics: national cross sectional study. BMJ. 2019;367:l6461.PubMedPubMedCentralCrossRef
72.
Lim JM, Singh SR, Duong MC, Legido-Quigley H, Hsu LY, Tam CC. Impact of national interventions to promote responsible antibiotic use: a systematic review. J Antimicrob Chemother. 2020;75(1):14–29.PubMedCrossRef
73.
Gonzales R, Malone DC, Maselli JH, Sande MA. Excessive antibiotic use for acute respiratory infections in the United States. Clin Infect Dis. 2001;33(6):757–62.PubMedCrossRef
74.
Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TMJ, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA. 2016;315(17):1864–73.PubMedCrossRef
75.
76.
Donskey CJ. Does improving surface cleaning and disinfection reduce health care-associated infections ? Am J Infect Control. 2013;41(5):S12–9.PubMedCrossRef
77.
Schinasi L, Wing S, MacDonald PDM, Richardson DB, Stewart JR, L. Augustino K, et al. Medical and Household Characteristics Associated with Methicillin Resistant Staphylococcus aureus Nasal Carriage among Patients Admitted to a Rural Tertiary Care Hospital. PLoS One. 2013;8(8).
78.
Creamer E, Dorrian S, Dolan A, Sherlock O, Fitzgerald-Hughes D, Thomas T, et al. When are the hands of healthcare workers positive for methicillin-resistant Staphylococcus aureus? J Hosp Infect. 2010;75(2):107–11.PubMedCrossRef
79.
Bearman G, Bryant K, Leekha S, Mayer J, Munoz-Price LS, Murthy R, et al. Healthcare personnel attire in non-operating-room settings. Infect Control Hosp Epidemiol. 2014;35(2):107–21.PubMedPubMedCentralCrossRef
80.
Roghmann M-C, Johnson JK, Sorkin JD, Langenberg P, Lydecker A, Sorace B, et al. Transmission of MRSA to healthcare personnel gowns and gloves during Care of Nursing Home Residents. Infect Control Hosp Epidemiol. 2015;36(9):1050–7.PubMedPubMedCentralCrossRef
81.
Lui JNM, Andres EB, Johnston JM. Presenteeism exposures and outcomes amongst hospital doctors and nurses: a systematic review. BMC Health Serv Res. 2018;18(1):985.PubMedPubMedCentralCrossRef
82.
Blok HEM, Troelstra A, Kamp-Hopmans TEM, Gigengack-Baars ACM, Vandenbroucke-Grauls CMJE, Weersink AJL, et al. Role of healthcare workers in outbreaks of methicillin-resistant Staphylococcus aureus: a 10-year evaluation from a Dutch university hospital. Infect Control Hosp Epidemiol. 2003;24(9):679–85.PubMedCrossRef
83.
Stock NK, Petráš P, Melter O, Kapounová G, Vopalková P, Kubele J, et al. Importance of Multifaceted Approaches in Infection Control: A Practical Experience from an Outbreak Investigation. PLoS One. 2016;11(6).
84.
Clements A, Halton K, Graves N, Pettitt A, Morton A, Looke D, et al. Overcrowding and understaffing in modern health-care systems: key determinants in meticillin-resistant Staphylococcus aureus transmission. Lancet Infect Dis. 2008;8(7):427–34.PubMedCrossRef
85.
Casey JA, Cosgrove SE, Stewart WF, Pollak J, Schwartz BS. A population-based study of the epidemiology and clinical features of methicillin-resistant Staphylococcus aureus infection in Pennsylvania, 2001–2010. Epidemiol Infect. 2013;141(6):1166–79.PubMedPubMedCentralCrossRef
86.
Turner NA, Sharma-kuinkel BK, Maskarinec SA, Eichenberger EM, Shah PP, Carugati M, et al. Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research. Nat Rev Microbiol. 2019;17(April):203–18.PubMedPubMedCentralCrossRef
87.
Kim MW, Greenfield BK, Snyder RE, Steinmaus CM, Riley LW. The association between community-associated Staphylococcus aureus colonization and disease: a meta-analysis. BMC Infect Dis. 2018;18(1):86.
88.
89.
Leonard FC, Markey BK. Meticillin-resistant Staphylococcus aureus in animals: a review. Vet J. 2008;175(1):27–36.PubMedCrossRef
90.
O’Mahony R, Abbott Y, Leonard FC, Markey BK, Quinn PJ, Pollock PJ, et al. Methicillin-resistant Staphylococcus aureus (MRSA) isolated from animals and veterinary personnel in Ireland. Vet Microbiol. 2005;109(3–4):285–96.PubMedCrossRef
91.
Couto N, Monchique C, Belas A, Marques C, Gama LT, Pomba C. Trends and molecular mechanisms of antimicrobial resistance in clinical staphylococci isolated from companion animals over a 16 year period. J Antimicrob Chemother. 2016;71(6):1479–87.PubMedCrossRef
92.
Harrison EM, Weinert LA, Holden MTG, Welch JJ, Wilson K, Morgan FJE, et al. A shared population of epidemic methicillin-resistant Staphylococcus aureus 15 circulates in humans and companion animals. MBio. 2014;5(3):e00985–13.PubMedPubMedCentralCrossRef
93.
Malik S, Peng H, Barton MD. Partial nucleotide sequencing of the mecA genes of Staphylococcus aureus isolates from cats and dogs. J Clin Microbiol. 2006;44(2):413–6.PubMedPubMedCentralCrossRef
94.
Baptiste KE, Williams K, Willams NJ, Wattret A, Clegg PD, Dawson S, et al. Methicillin-resistant staphylococci in companion animals. Emerg Infect Dis. 2005;11(12):1942–4.PubMedPubMedCentralCrossRef
95.
Ferreira JP, Anderson KL, Correa MT, Lyman R, Ruffin F, Reller LB, et al. Transmission of MRSA between Companion Animals and Infected Human Patients Presenting to Outpatient Medical Care Facilities. PLoS One. 2011;6(11).
96.
Faires MC, Tater KC, Weese S. An investigation of methicillin-resistant Staphylococcus aureus colonization in people and pets in the same household with an infected person or infected pet. JAVMA. 2009;235:540–3.PubMedCrossRef
97.
Damborg P, Top J, Hendrickx APA, Dawson S, Willems RJL, Guardabassi L. Dogs are a reservoir of ampicillin-resistant Enterococcus faecium lineages associated with human infections. Appl Environ Microbiol. 2009;75(8):2360–5.PubMedPubMedCentralCrossRef
98.
Gomez-Sanz E, Torres C, Lozano C, Zarazaga M. High diversity of Staphylococcus aureus and Staphylococcus pseudintermedius lineages and toxigenic traits in healthy pet-owning household members. Underestimating normal household contact? Comp Immunol Microbiol Infect Dis. 2013;36(1):83–94.PubMedCrossRef
99.
Kwon KH, Moon BY, Hwang SY, Park YH. Detection of CC17 Enterococcus faecium in dogs and a comparison with human isolates. Zoonoses Public Health. 2012;59(6):375–8.PubMedCrossRef
100.
van de Sande-Bruinsma N, Leverstein van Hall MA, Janssen M, Nagtzaam N, Leenders S, de Greeff SC, et al. Impact of livestock-associated MRSA in a hospital setting. Antimicrob Resist Infect Control. 2015;4(1):11.
101.
van Rijen MML, van Keulen PH, Kluytmans JA. Increase in a Dutch hospital of methicillin-resistant Staphylococcus aureus related to animal farming. Clin Infect Dis. 2008;46(2):261–3.PubMedCrossRef
102.
Wulf MWH, Tiemersma E, Kluytmans J, Bogaers D, Leenders ACAP, Jansen MWH, et al. MRSA carriage in healthcare personnel in contact with farm animals. J Hosp Infect. 2008;70(2):186–90.PubMedCrossRef
103.
Cefai C, Ashurst S, Owens C. Human carriage of methicillin-resistant Staphylococcus aureus linked with pet dog. Lancet (London, England). 1994;344:539–40 England.CrossRef
104.
Scott GM, Thomson R, Malone-Lee J, Ridgway GL. Cross-infection between animals and man: possible feline transmission of Staphylococcus aureus infection in humans? J Hosp Infect. 1988;12(1):29–34.PubMedCrossRef
105.
Lefebvre SL, Waltner-Toews D, Peregrine AS, Reid-Smith R, Hodge L, Arroyo LG, et al. Prevalence of zoonotic agents in dogs visiting hospitalized people in Ontario: implications for infection control. J Hosp Infect. 2006;62(4):458–66.PubMedCrossRef
106.
Enoch DA, Karas JA, Slater JD, Emery MM, Kearns AM, Farrington M. MRSA carriage in a pet therapy dog. J Hosp Infect. 2005;60(2):186–8.PubMedCrossRef
107.
Lefebvre SL, Reid-Smith RJ, Waltner-Toews D, Weese JS. Incidence of acquisition of methicillin-resistant Staphylococcus aureus, Clostridium difficile, and other healthcare–associated pathogens by dogs that participate in animal-assisted interventions. JAVMA. 2009;234(11):1404-17.
108.
Lefebvre SL, Arroyo LG, Weese JS. Epidemic Clostridium difficile strain in hospital visitation dog Streptobacillus moniliformis endocarditis. Emerg Infect Dis. 2006;12(6):6–7.CrossRef
109.
Leonard FC, Abbott Y, Rossney A, Quinn PJ, O’Mahony R, Markey BK. Methicillin-resistant Staphylococcus aureus isolated from a veterinary surgeon and five dogs in one practice. Vet Rec. 2006;158(5):155–9.PubMedCrossRef
110.
Weese JS, Dick H, Willey BM, McGeer A, Kreiswirth BN, Innis B, et al. Suspected transmission of methicillin-resistant Staphylococcus aureus between domestic pets and humans in veterinary clinics and in the household. Vet Microbiol. 2006;115(1–3):148–55.PubMedCrossRef
111.
Drougka E, Foka A, Koutinas CK, Jelastopulu E, Giormezis N, Farmaki O, et al. Interspecies spread of Staphylococcus aureus clones among companion animals and human close contacts in a veterinary teaching hospital. A cross-sectional study in Greece. Prev Vet Med. 2016;126:190–8.PubMedCrossRef
112.
Rodrigues AC, Belas A, Marques C, Cruz L, Gama LT, Pomba C. Risk factors for nasal colonization by methicillin-resistant staphylococci in healthy humans in professional daily contact with companion animals in Portugal. Microb Drug Resist. 2018;24(4):434–46.PubMedCrossRef
113.
Worthing KA, Brown J, Gerber L, Trott DJ, Abraham S, Norris JM. Methicillin-resistant staphylococci amongst veterinary personnel, personnel-owned pets, patients and the hospital environment of two small animal veterinary hospitals. Vet Microbiol. 2018;223:79–85.PubMedCrossRef
114.
Loeffler A, Pfeiffer DU, Lloyd DH, Smith H, Soares-Magalhaes R, Lindsay JA. Meticillin-resistant Staphylococcus aureus carriage in UK veterinary staff and owners of infected pets: new risk groups. J Hosp Infect. 2010;74(3):282–8.PubMedCrossRef
115.
Bai Z, Zhang H, Li N, Bai Z, Zhang L, Xue Z, et al. Impact of environmental microbes on the composition of the gut microbiota of adult BALB/c mice. PLoS One. 2016;11(8):e0160568.PubMedPubMedCentralCrossRef
116.
Zipperer A, Konnerth MC, Laux C, Berscheid A, Janek D, Weidenmaier C, et al. Human commensals producing a novel antibiotic impair pathogen colonization. Nature. 2016;535(7613):511–6.PubMedCrossRef
117.
Hogan PG, Mork RL, Boyle MG, Muenks CE, Morelli JJ, Thompson RM, et al. Interplay of personal, pet, and environmental colonization in households affected by community-associated methicillin-resistant Staphylococcus aureus. J Inf Secur. 2019;78(3):200–7.
118.
Morris DO, Loeffler A, Davis MF, Guardabassi L, Weese JS. Recommendations for approaches to meticillin-resistant staphylococcal infections of small animals: diagnosis, therapeutic considerations and preventative measures.: Clinical Consensus Guidelines of the World Association for Veterinary Dermatology. Vet Dermatol. 2017;28(3):304-e69.
119.
Lefebvre SL, Golab JS, Christensen E, Castrodale L, Aureden K, Bialachowski A, et al. Guidelines for animal-assisted interventions in health care facilities. Am J Infect Control. 2008;36(7):78–85.PubMedCrossRef
120.
Dalton K, Ruble K, DeLone A, Frankefield P, Walker D, Ludwig S, et al. 160. Reduction in the Spread of Hospital-Associated Infections Among Pediatric Oncology Patients in an Animal-Assisted Intervention Program from a Canine Decolonization Procedure. OFID. 2018;5(Suppl 1):2018 September 2017.
121.
Murthy R, Bearman G, Brown S, Bryant K, Chinn R, Hewlett A, et al. Animals in healthcare facilities : recommendations to minimize potential risks. Infect Control Hosp Epidemiol. 2015;36(5):495–516.PubMedCrossRef
122.
Silbergeld EK, Davis M, Leibler JH, Peterson AE. One reservoir: redefining the community origins of antimicrobial-resistant infections. Med Clin NA. 2008;92(6):1391–407 xi.
123.
Schinasi L, Wing S, L Augustino K, Ramsey KM, Nobles DL, Richardson DB, et al. A case control study of environmental and occupational exposures associated with methicillin resistant Staphylococcus aureus nasal carriage in patients admitted to a rural tertiary care hospital in a high density swine region. Environ Health. 2014;13(1):54.PubMedPubMedCentralCrossRef
124.
O’Connor AM, Auvermann BW, Dzikamunhenga RS, Glanville JM, Higgins JPT, Kirychuk SP, et al. Updated systematic review: associations between proximity to animal feeding operations and health of individuals in nearby communities. Syst Rev. 2017;6(1):86.PubMedPubMedCentralCrossRef
125.
McEwen SA, Collignon PJ. Antimicrobial Resistance: a One Health Perspective. Microbiol Spectr. 2018;6(2):521-47.
126.
Richter CH, Custer B, Steele JA, Wilcox BA, Xu J. Intensified food production and correlated risks to human health in the greater Mekong subregion: a systematic review. Environ Health. 2015;14:43.PubMedPubMedCentralCrossRef
127.
Goerge T, Lorenz MB, van Alen S, Hubner N-O, Becker K, Kock R. MRSA colonization and infection among persons with occupational livestock exposure in Europe: prevalence, preventive options and evidence. Vet Microbiol. 2017;200:6–12.PubMedCrossRef
128.
Michalsen A, Delclos GL, Felknor SA, Davidson AL, Johnson PC, Vesley D, et al. Compliance with universal precautions among physicians. J Occup Environ Med. 1997;39(2):130–7.PubMedCrossRef
129.
Ganczak M, Szych Z. Surgical nurses and compliance with personal protective equipment. J Hosp Infect. 2007;66(4):346–51.PubMedCrossRef
130.
McGovern PM, Vesley D, Kochevar L, Gershon RRM, Rhame FS, Anderson E. Factors affecting universal precautions compliance. J Bus Psychol. 2000;15(1):149–61.CrossRef
131.
Harrod M, Weston LE, Gregory L, Petersen L, Mayer J, Drews FA, et al. A qualitative study of factors affecting personal protective equipment use among health care personnel. Am J Infect Control. 2019;000:1–6.
132.
Dancer SJ. The role of environmental cleaning in the control of hospital-acquired infection. J Hosp Infect. 2009;73(4):378–85.PubMedCrossRef
133.
Rutala WA, Weber DJ. Surface disinfection: should we do it? J Hosp Infect. 2001;48(Suppl A):S64–8.PubMedCrossRef
134.
Dharan S, Mourouga P, Copin P, Bessmer G, Tschanz B, Pittet D. Routine disinfection of patients’ environmental surfaces. Myth or reality? J Hosp Infect. 1999;42(2):113–7.PubMedCrossRef
135.
Rutala WA, Gergen MF, Weber DJ. Impact of an oil-based lubricant on the effectiveness of the sterilization processes. Infect Control Hosp Epidemiol. 2008;29(1):69–72.PubMedCrossRef
136.
Quinn MM, Henneberger PK, Braun B, Delclos GL, Fagan K, Pharmd VH, et al. Cleaning and disinfecting environmental surfaces in health care: toward an integrated framework for infection and occupational illness prevention. Am J Infect Control. 2015;43(5):424–34.PubMedCrossRef
137.
Snyder GM, Holyoak AD, Leary KE, Sullivan BF, Davis RB, Wright SB. Effectiveness of visual inspection compared with non-microbiologic methods to determine the thoroughness of post-discharge cleaning. Antimicrob Resist Infect Control. 2013;2(1):26.PubMedPubMedCentralCrossRef
138.
Hota B, Blom DW, Lyle EA, Weinstein RA, Hayden MK. Interventional evaluation of environmental contamination by vancomycin-resistant enterococci: failure of personnel, product, or procedure? J Hosp Infect. 2009;71(2):123–31.PubMedCrossRef
139.
Vickery K, Deva A, Jacombs A, Allan J, Valente P, Gosbell IB. Presence of biofilm containing viable multiresistant organisms despite terminal cleaning on clinical surfaces in an intensive care unit. J Hosp Infect. 2012;80(1):52–5.PubMedCrossRef
140.
Pidot SJ, Gao W, Buultjens AH, Monk IR, Guerillot R, Carter GP, et al. Increasing tolerance of hospital Enterococcus faecium to handwash alcohols. Sci Transl Med. 2018;10(452):eaar6115.PubMedCrossRef
141.
Mitchell BG, Hall L, White N, Barnett AG, Halton K, Paterson DL, et al. An environmental cleaning bundle and health-care-associated infections in hospitals (REACH): a multicentre, randomised trial. Lancet Infect Dis. 2019;19(4):410–8.PubMedCrossRef
142.
Vietri NJ, Dooley DP, Davis CE, Longfield JN, Meier PA, Whelen AC. The effect of moving to a new hospital facility on the prevalence of methicillin-resistant Staphylococcus aureus. Am J Infect Control. 2004;32(5):262–7.PubMedCrossRef
143.
Boyce JM, Farrel PA, Towle D, Fekieta R, Aniskiewicz M. Impact of room location on UV-C irradiance and UV-C dosage and antimicrobial effect delivered by a Mobile UV-C light device. Infect Control Hosp Epidemiol. 2016;37(6):667–72.PubMedPubMedCentralCrossRef
144.
Rock C, Curless MS, Nowakowski E, Ross T, Carson KA, Trexler P, et al. UV-C light disinfection of Carbapenem-resistant Enterobacteriaceae from high-touch surfaces in a patient room and bathroom. Infect Control Hosp Epidemiol. 2016;37(8):996–7.PubMedCrossRef
145.
Chyderiotis S, Legeay C, Verjat-Trannoy D, Le Gallou F, Astagneau P, Lepelletier D. New insights on antimicrobial efficacy of copper surfaces in the healthcare environment: a systematic review. Clin Microbiol Infect. 2018;24(11):1130–8.PubMedCrossRef
146.
Kim MH, Lee SG, Kim KS, Heo YJ, Oh JE, Jeong SJ. Environmental disinfection with photocatalyst as an adjunctive measure to control transmission of methicillin-resistant Staphylococcus aureus: a prospective cohort study in a high-incidence setting. BMC Infect Dis. 2018;18(1):610.
147.
Falagas ME, Thomaidis PC, Kotsantis IK, Sgouros K, Samonis G, Karageorgopoulos DE. Airborne hydrogen peroxide for disinfection of the hospital environment and infection control: a systematic review. J Hosp Infect. 2011;78(3):171–7.PubMedCrossRef
148.
Boswell TC, Fox PC. Reduction in MRSA environmental contamination with a portable HEPA-filtration unit. J Hosp Infect. 2006;63(1):47–54.PubMedCrossRef
149.
Farbman L, Avni T, Rubinovitch B, Leibovici L, Paul M. Cost-benefit of infection control interventions targeting methicillin-resistant Staphylococcus aureus in hospitals: systematic review. Clin Microbiol Infect. 2013;19(12):E582–93.PubMedCrossRef
150.
Afonso E, Llaurado M, Gallart E. The value of chlorhexidine gluconate wipes and prepacked washcloths to prevent the spread of pathogens--a systematic review. Aust Crit Care. 2013;26(4):158–66.PubMedCrossRef
151.
Murni I, Duke T, Triasih R, Kinney S, Daley AJ, Soenarto Y. Prevention of nosocomial infections in developing countries, a systematic review. Paediatr Int Child Health. 2013;33(2):61–78.PubMedCrossRef
152.
Huis A, van Achterberg T, de Bruin M, Grol R, Schoonhoven L, Hulscher M. A systematic review of hand hygiene improvement strategies: a behavioural approach. Implement Sci. 2012;7:92.PubMedPubMedCentralCrossRef
153.
van Trijp MJCA, Melles DC, Hendriks WDH, Parlevliet GA, Gommans M, Ott A. Successful control of widespread methicillin-resistant Staphylococcus aureus colonization and infection in a large teaching hospital in the Netherlands. Infect Control Hosp Epidemiol. 2007;28(8):970–5.PubMedCrossRef
154.
van Rijen MML, Kluytmans JAJW. Costs and benefits of the MRSA search and destroy policy in a Dutch hospital. Eur J Clin Microbiol Infect Dis. 2009;28(10):1245–52.PubMedCrossRef
155.
Pierce R, Lessler J, Popoola VO, Milstone AM. MRSA acquisition risk in an endemic NICU setting with an active surveillance culture and decolonization program. J Hosp Infect. 2017;95(1):91–7.PubMedCrossRef
156.
Peterson A, Marquez P, Terashita D, Burwell L, Mascola L. Hospital methicillin-resistant Staphylococcus aureus active surveillance practices in Los Angeles County: implications of legislation-based infection control, 2008. Am J Infect Control. 2010;38(8):653–6.PubMedCrossRef
157.
Kurup A, Chlebicka N, Tan KY, Chen EX, Oon L, Ling TA, et al. Active surveillance testing and decontamination strategies in intensive care units to reduce methicillin-resistant Staphylococcus aureus infections. Am J Infect Control. 2010;38(5):361–7.PubMedCrossRef
158.
Weber SG, Huang SS, Oriola S, Huskins WC, Noskin GA, Harriman K, et al. Legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci: position statement from the joint SHEA and APIC task force. Infect Control Hosp Epidemiol. 2007;28(3):249–60.PubMedCrossRef
159.
Mangini E, Segal-Maurer S, Burns J, Avicolli A, Urban C, Mariano N, et al. Impact of contact and droplet precautions on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus infection. Infect Control Hosp Epidemiol. 2007;28(11):1261–6.PubMedCrossRef
160.
Rock C, Small BA, Hsu Y-J, Gurses AP, Xie A, Scheeler V, et al. Evaluating accuracy of sampling strategies for fluorescent gel monitoring of patient room cleaning. Infect Control Hosp Epidemiol. 2019;40(7):794–7.PubMedPubMedCentralCrossRef
161.
Rock C, Xie A, Andonian J, Hsu Y-J, Osei P, Keller SC, et al. Evaluation of environmental cleaning of patient rooms: impact of different fluorescent gel markers. Infect Control Hosp Epidemiol. 2019;40(1):100–2.PubMedCrossRef
162.
Luangasanatip N, Hongsuwan M, Limmathurotsakul D, Lubell Y, Lee AS, Harbarth S, et al. Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. BMJ. 2015;351:h3728.PubMedPubMedCentralCrossRef
163.
Weese JS, DaCosta T, Button L, Goth K, Ethier M, Boehnke K. Isolation of methicillin-resistant Staphylococcus aureus from the environment in a veterinary teaching hospital. J Vet Intern Med. 2004;18(4):468–70.PubMedCrossRef
164.
Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis An Off Publ Infect Dis Soc Am. 2016;62(10):e51–77.CrossRef
165.
Yvonne L, Selinger J, Anthony M, Rudkin J, Crabb H, Billman-jacobe H, et al. Population wide assessment of antimicrobial use in dogs and cats using a novel data source – a cohort study using pet insurance data. Vet Microbiol. 2018;225(August):34–9.
166.
Davis MF, Rankin SC, Schurer JM, Cole S, Conti L, Rabinowitz P. Checklist for one health epidemiological reporting of evidence (COHERE). One Health. 2017;4:14–21.PubMedPubMedCentralCrossRef
167.
Sargeant JM, O’Connor AM, Dohoo IR, Erb HN, Cevallos M, Egger M, et al. Methods and processes of developing the strengthening the reporting of observational studies in epidemiology - veterinary (STROBE-vet) statement. Prev Vet Med. 2016;134:188–96.PubMedCrossRef
168.
Ege MJ, Mayer M, Normand A-C, Genuneit J, Cookson WOCM, Braun-Fahrländer C, et al. Exposure to environmental microorganisms and childhood asthma. N Engl J Med. 2011;364(8):701–9.PubMedCrossRef
169.
Song SJ, Lauber C, Costello EK, Lozupone CA, Humphrey G, Berg-Lyons D, et al. Cohabiting family members share microbiota with one another and with their dogs. Elife. 2013;2:e00458.PubMedPubMedCentralCrossRef
170.
Trinh P, Zaneveld JR, Safranek S, Rabinowitz P. One health relationships between human, animal, and environmental microbiomes: a mini-review. Front Public Health. 2018;6(August):235.PubMedPubMedCentralCrossRef
Metadata
Title
One Health in hospitals: how understanding the dynamics of people, animals, and the hospital built-environment can be used to better inform interventions for antimicrobial-resistant gram-positive infections
Authors
Kathryn R. Dalton
Clare Rock
Karen C. Carroll
Meghan F. Davis
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2020
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-020-00737-2

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