Rate of nosocomial MRSA transmission evaluated via contact screening.

IF 4.8 2区医学 Q1 INFECTIOUS DISEASES

Antimicrobial Resistance and Infection Control Pub Date : 2024-08-27 DOI:10.1186/s13756-024-01448-8

Maria Konstantinovski, Crista van Geest, Marguerite Bruijning, Lindsay Kroon-de Keizer, Jacco Wallinga, Nathalie van Burgel, Karin-Ellen Veldkamp

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引用次数: 0

Abstract

Background: The prevention of methicillin-resistant S. aureus (MRSA) transmission in the healthcare setting is a priority in Infection Control practices. A cornerstone of this policy is contact tracing of nosocomial contacts after an unexpected MRSA finding. The objective of this retrospective study was to quantify the rates of MRSA transmission in different clinical settings.

Methods: This multi-centre study included MRSA contact screening results from two regional hospitals and one academic hospital. MRSA contact tracing investigations from 2000 until 2019 were reviewed and post-contact screening results were included of index patients with an MRSA-positive culture and their unprotected contacts. Available typing results were used to rule out incidental findings.

Results: Of 27,377 contacts screened after MRSA exposure, 21,488 were Health Care Workers (HCW) and 4816 patients. Post-contact screening was initiated for a total of 774 index cases, the average number of screened contacts per index case was 35.7 (range 1 to 640). MRSA transmission was observed in 0.15% (41) of the contacts, 19 (0.09%) HCW and 22 (0.46%) patients. The number needed to screen to detect one MRSA transmission was 667. The highest risk of MRSA transmission occurred during patient-to-patient contacts, with transmission rates varying from 0.32 to 1.32% among the participating hospitals. No transmissions were detected in HCW (n=2834) in the outpatient setting, and the rate of transmissions among HCW contacts on the wards was 0.13% (19 of 15,874). Among 344 contacts of patients with contact precautions, no transmissions were detected.

Conclusions: Reconsidering current MRSA contact tracing practices may lead to a more targeted approach with a lower number needed to screen.

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通过接触筛查评估院内 MRSA 传播率。

背景：预防耐甲氧西林金黄色葡萄球菌（MRSA）在医疗环境中的传播是感染控制工作的重点。这一政策的基石是在意外发现 MRSA 后对医院内接触者进行接触追踪。这项回顾性研究旨在量化不同临床环境中的 MRSA 传播率：这项多中心研究包括两家地区医院和一家学术医院的 MRSA 接触者筛查结果。研究回顾了 2000 年至 2019 年期间的 MRSA 接触者追踪调查，并纳入了 MRSA 培养呈阳性的指数患者及其无保护接触者的接触后筛查结果。现有的分型结果用于排除偶然发现：在暴露于 MRSA 后接受筛查的 27,377 名接触者中，21,488 人为医护人员 (HCW)，4816 人为患者。共对 774 例指数病例进行了接触后筛查，每例指数病例的平均筛查接触人数为 35.7 人（范围为 1-640 人）。在 0.15%（41 人）的接触者、19（0.09%）名医务人员和 22（0.46%）名患者中观察到 MRSA 传播。发现一次 MRSA 传播所需的筛查人数为 667 人。MRSA 传播的最高风险发生在患者与患者之间的接触中，参与医院的传播率从 0.32% 到 1.32% 不等。在门诊环境中未发现人机共用工作者（n=2834）传播MRSA，病房中人机共用工作者接触者的传播率为0.13%（15874人中有19人）。在344名采取接触预防措施的患者接触者中，未发现任何传播：重新考虑目前的 MRSA 接触者追踪方法可能会使筛查更有针对性，所需人数更少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

9.70

自引率

3.60%

发文量

140

审稿时长

13 weeks

期刊介绍： Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.