Methicillin-resistant Staphylococcus aureus has greater risk of transmission in the operating room than methicillin-sensitive S aureus - 28/04/18
, Franklin Dexter, MD, PhD b, Alysha D.M. Robinson, BS cHighlights |
• | Staphylococcus aureus pathogens are frequently transmitted in the operating room environment. |
• | Methicillin-resistant S aureus is more transmissible than methicillin-sensitive S aureus. |
Abstract |
Background |
Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogenic S aureus strain characteristic associated with increased patient morbidity and mortality. The health care system needs to understand MRSA transmissibility in all settings to improve basic preventive measures to generate sustained reductions in invasive MRSA infections. Our primary aim was to compare intraoperative transmissibility of MRSA versus methicillin-sensitive S aureus (MSSA) isolates.
Methods |
S aureus isolates (N = 173) collected from 274 randomly selected operating room environments (first and second case of the day in each operating room, a case pair) at 3 hospitals underwent systematic-phenotypic and genomic processing to identify clonally related transmission events. Confirmed transmission events were defined as at least 2 S aureus isolates obtained from ≥2 distinct intraoperative reservoirs sampled within or between cases in a study unit that were epidemiologically and clonally related. We explored the relationship between clonal transmission and methicillin resistance with Poisson regression analysis.
Results |
We identified 58 clonal transmission events. MRSA isolates were associated with increased risk of clonal transmission compared with MSSA isolates (adjusted incidence risk ratio [IRR], 1.68; 95% confidence interval [CI], 1.13-2.49; P = .010; unadjusted IRR, 1.85; 95% CI, 1.23-2.77; P = .003, respectively).
Conclusions |
MRSA isolates are associated with increased risk of intraoperative transmission. Future work should examine the impact of the attenuation of intraoperative MRSA transmission on the incidence of invasive MRSA infections.
El texto completo de este artículo está disponible en PDF.Key Words : Intraoperative, transmission, MRSA, MSSA
Esquema
| Funding/support: Supported by The University of Iowa. |
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| Conflicts of interest: R.W.L. reports research funding from Sage Medical, has ≥1 patents pending, and is a shareholder in RDB Bioinformatics. A.D.M.R. and F.D. have no conflicts of interest. |
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| Author contributions: R.W.L. helped design the study, conduct the study, analyze the data, and write the manuscript. F.D. helped analyze the data and write the manuscript. A.D.M.R. helped conduct the study. All authors approved the final version of the manuscript. |
Vol 46 - N° 5
P. 520-525 - mai 2018 Regresar al número
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