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Methicillin-resistant Staphylococcus aureus in a teaching hospital: investigation of nosocomial transmission using a matched case-control study.
- Source :
-
The Journal of hospital infection [J Hosp Infect] 2000 Dec; Vol. 46 (4), pp. 263-70. - Publication Year :
- 2000
-
Abstract
- In early 1996 a hospital-wide methicillin-resistant Staphylococcus aureus (MRSA) epidemic was recognized in a 900-bed university hospital. In order to investigate hospital-specific transmission routes, a case-control study was carried out. Cases and controls were matched for age (+/- 10 years), sex, admission date (+/- 10 days) and clinical department on admission. Data on potential risk factors, were retrieved by chart review. Between June 1996 and February 1997, 67 patients with hospital-acquired MRSA were identified. Molecular typing showed that 85% of the cases carried an indistinguishable strain. The average time at risk for cases and controls was 17.3 and 23.7 days, respectively (P= 0.01). Seventeen patients (25.4%) developed infection. Conditional multivariate regression analysis showed that intensity of care (P= 0.002), number of transfers (P= 0.019), and fluoroquinolone therapy (P= 0.025) were independently associated with acquisition of MRSA. Intensity of care can be considered as a surrogate marker for a number of manipulations which represent the main risk factors for MRSA transmission. Frequent transfers within the hospital hinder, not only the epidemiological analyses, but also efforts to bring an outbreak under control. Our findings give epidemiological support to recent molecular studies which suggest that fluoroquinolone use may increase the transmissibility of MRSA in hospitals.<br /> (Copyright 2000 The Hospital Infection Society.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Anti-Infective Agents adverse effects
Case-Control Studies
Cross Infection epidemiology
Cross Infection microbiology
Cross Infection prevention & control
DNA Fingerprinting
DNA, Bacterial analysis
DNA, Bacterial genetics
Disease Outbreaks prevention & control
Female
Fluoroquinolones
Germany epidemiology
Humans
Male
Matched-Pair Analysis
Middle Aged
Multivariate Analysis
Patient Transfer
Polymerase Chain Reaction
Regression Analysis
Risk Factors
Serotyping
Staphylococcal Infections epidemiology
Staphylococcal Infections microbiology
Staphylococcal Infections prevention & control
Cross Infection transmission
Disease Outbreaks statistics & numerical data
Hospitals, University
Infection Control methods
Methicillin Resistance
Staphylococcal Infections transmission
Staphylococcus aureus classification
Subjects
Details
- Language :
- English
- ISSN :
- 0195-6701
- Volume :
- 46
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of hospital infection
- Publication Type :
- Academic Journal
- Accession number :
- 11170757
- Full Text :
- https://doi.org/10.1053/jhin.2000.0846