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Carriage of Multiple Subtypes of Methicillin-Resistant Staphylococcus aureus by Intensive Care Unit Patients

Published online by Cambridge University Press:  21 June 2016

Megan S. C. Lim ,
Caroline L. Marshall  and
Denis Spelman
Megan S. C. Lim*
Affiliation:
Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
Caroline L. Marshall
Affiliation:
Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
Denis Spelman
Affiliation:
Department of Microbiology, Alfred Hospital, Melbourne, Australia
*
Centre for Epidemiology and Population Health Research, The Macfarlane Burnet Institute for Medical Research and Public Health, GPO Box 2284, Melbourne, 3001, Australia, (lim@burnet.edu.au)
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Extract

Objective:

To determine how consistently patients are colonized with methicillin-resistant Staphylococcus aureus (MRSA) at various sites and how many subtypes can be carried simultaneously by a single patient.

Setting.

A 28-bed Intensive care unit in a tertiary-care referral hospital.

Methods.

A total of 1,181 patients were screened by culture of swab specimens obtained from the nose, throat, groin, and axilla on admission to the intensive care unit (ICU), twice weekly during their ICU stay, and at discharge.

Results.

MRSA was isolated at least once from 224 patients. Of these isolates, 359 were selected from 32 patients to be subtyped using pulsed-field gel electrophoresis. The rate of compliance with collection of swab specimens was 79.9%. The combination of sites colonized varied frequently over time for many patients. Of patients who had swab specimens obtained twice in 1 day, 8.7% had discordant results from the 2 swab sets. No patient had a clinical isolate that was not of an identical subtype to an isolate from an anatomical site that was sampled for screening. Half the patients carried multiple subtypes during their stay, with up to 4 subtypes per patient.

Conclusions.

The findings of this study may indicate that these patients have been colonized with MRSA on more than one occasion, possibly because of multiple breaches in infection control procedure. In MRSA-colonized patients, anatomical sites were intermittently colonized and carriage of multiple subtypes was common. These findings indicate that MRSA carriage is not a fixed state but may vary over time.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 10 , October 2006 , pp. 1063 - 1067
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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