bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antimicrobial Resistance in Staphylococcus aureus at the University of Chicago Hospitals: A 15-Year Longitudinal Assessment in a Large University-Based Hospital
Authors: Seal John B. , Moreira Beatriz , Bethel Cindy D. , Daum Robert S. 
Published: March 2006

AbstractObjectives:To describe a longitudinal profile of resistance to beta-lactam antimicrobials among isolates of Staphylococcus aureus at a large university teaching hospital and to evaluate the impact of the methicillin resistance phenotype on resistance trends for non-beta-lactam antimicrobials.Design:Retrospective evaluation of antimicrobial susceptibility data for all 17,287 S. aureus isolates obtained from January 1986 through December 2000.Setting:The University of Chicago Hospitals, a family of tertiary-care, university-affiliated hospitals in Chicago, Illinois, consisting of 547 adult and pediatric beds.Results:The annual rate of resistance to methicillin increased from 13% in 1986 to 28% in 2000 (P < .001) and has not plateaued. For each non-beta-lactam antimicrobial tested, the annual rates of resistance were far higher among methicillinresistant S. aureus (MRSA) isolates than among methicillin-susceptible S. aureus (MSSA) isolates. The annual rates of resistance to the macrolide, lincosamide, and streptogramin (MLS) antimicrobials erythromycin and clindamycin increased among MSSA isolates (P < .01), but remained lower than 20%. Resistance to the MLS antimicrobials was higher among MRSA isolates (higher than 60%), but the annual rate decreased significantly during the study (P < .01).Conclusion:The prevalence of methicillin resistance among S. aureus isolates has continued to increase; resistance to non-beta-lactam antimicrobials is far more common among MRSA isolates. Recent decreases in the proportion of MRSA isolates resistant to non-beta-lactam antimicrobials suggest important changes in the epidemiology of this pathogen.
Prevalence of and Risk Factors for Colonization With Methicillin-ResistantStaphylococcus aureusin an Outpatient Clinic Population
Authors: Jernigan John A. , Pullen Amy L. , Partin Clyde , Jarvis William R. 
Published: March 2006

AbstractObjecttves:To determine the prevalence of methicillin-resistantStaphylococcus aureus(MRSA) colonization in an outpatient population and to identify risk factors for MRSA colonization.Design:Surveillance cultures were performed during outpatient visits to identify S.aureuscolonization. A case-control study was performed to identify risk factors for MRSA colonization.Setting:Primary care internal medicine clinic. PATTENTS: Adults presenting for non-acute primary care (N = 494).Results:S.aureuswas isolated from 122 (24.7%) of the patients for whom cultures were performed. Methicillin-susceptible S.aureuswas isolated from 107 (21.7%) of the patients, whereas MRSA was isolated from 15 (3.0%) of the patients. All MRSA isolates were resistant to multiple non-beta-lactam antimicrobial agents. In multivariate analyses, MRSA colonization was independently associated with admission to a nursing home (adjusted odds ratio [OR], 103; 95% confidence interval [CI95], 7 to 999) or hospital in the previous year, although the association with hospital admission was observed only among those without chronic illness (adjusted OR 7.1; CI95, 1.3 to 38.1). In addition, MRSA colonization was associated with the presence of at least one underlying chronic illness, although this association was observed only among those who had not been hospitalized in the previous year (adjusted OR, 5.1; CI95, 1.2 to 21.9).Conclusions:We found a low prevalence of MRSA colonization in an adult outpatient population. MRSA carriers most likely acquired the organism through contact with healthcare facilities rather than in the community. These data show that care must be taken when attributing MRSA colonization to the community if detected in outpatients or during the first 24 to 48 hours of hospitalization.
Nosocomial Transmission of Methicillin-Resistant Staphylococcus aureus: A Blinded Study to Establish Baseline Acquisition Rates
Authors: Fishbain Joel T. , Lee Joseph C. , Nguyen Honghung D. , Mikita Jeffery A. , Mikita Cecilia P. , Uyehara Catherine F. T. , Hospenthal Duane R. 
Published: March 2006

AbstractObjective:To define the extent of nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to a tertiary-care hospital.Design:A blinded, prospective surveillance culture study of patients admitted to the hospital to determine the transmission (acquisition) rate of MRSA Risk factors associated with the likelihood of MRSA colonization on admission were investigated.Setting:Tertiary-care military medical facility.Participants:All patients admitted to the medicine, surgery, and pediatric wards, and to the medical, surgical, and pediatric intensive care units were eligible for inclusion.Results:Five hundred thirty-five admission and 374 discharge samples were collected during the study period. One hundred forty-one patients were colonized with methicillin-susceptible S. aureus (MSSA) and 20 patients (3.7%) were colonized with MRSA on admission. Of the 354 susceptible patients, 6 acquired MRSA during the study for a transmission rate of 1.7%. Patients colonized with MRSA on admission were more likely to be older than non-colonized or MSSA-colonized patients, to have received antibiotics within the past year, to have been hospitalized within the prior 3 years, or to have a known history of MRSA. Patients acquiring MRSA had an average hospital stay of 17.7 days compared with 5.3 days for those who did not acquire MRSA. Pulsed-field gel electrophoresis of the 6 MRSA isolates from patients who acquired MRSA revealed 4 distinct band patterns.Conclusions:Most patients colonized with MRSA were identified on admission samples. Surveillance cultures of patients admitted may help to prevent MRSA transmission and infection.
Spread of Methicillin-ResistantStaphylococcus aureus(MRSA) Among Household Contacts of Individuals With Nosocomially Acquired MRSA
Authors: Calfee David P. , Durbin Lisa J. , Germanson Teresa P. , Toney Denise M. , Smith Elise B. , Farr Barry M. 
Published: March 2006

AbstractObjective:To determine the frequency with which methicillin-resistantStaphylococcus aureus(MRSA) is spread from colonized or infected patients to their household and community contacts.Design:Retrospective cohort study.Setting:University hospital.Participants:Household and community contacts of MRSA-colonized or -infected patients for whom MRSA screening cultures were performed.Results:MRSA was isolated from 25 (14.5%) of 172 individuals. Among the contacts of index patients who had at least one MRSA-colonized contact, those with close contact to the index patient were 7.5 times more likely to be colonized (53% vs 7%; 95% confidence interval, 1.1 to 50.3;P= .002). An analysis of antimicrobial susceptibility and DNA fingerprint patterns suggested person-to-person spread.Conclusions:MRSA colonization occurs frequently among household and community contacts of patients with nosocomially acquired MRSA, suggesting that transmission of nosocomially acquired MRSA outside of the healthcare setting may be a substantial source of MRSA colonization and infection in the community.
Epidemiology of Methicillin-Resistant Staphylococcus aureus at a Children's Hospital
Authors: Campbell Andrew L. , Bryant Kristina A. , Stover Beth , Marshall Gary S. 
Published: March 2006

AbstractObjective:To describe the relative contribution of and risk factors for both community-acquired and nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections.Design:Retrospective cohort study.Setting:270-bed, tertiary-care children's hospital.Participants:All MRSA-infected children from whom MRSA was recovered between October 1, 1999, and September 30, 2001.Methods:Demographic, clinical, and risk factor data were abstracted from medical records. Categorical variables were analyzed using the chi-square or Fisher's exact test and continuous variables were analyzed using the Mann-Whitney test.Results:Of the 62 patients with new MRSA infection, 37 had community-acquired MRSA and 25 had nosocomial MRSA. Most community-acquired MRSA infections were of the skin and soft tissue, the middle ear, and the lower respiratory tract. Nosocomial MRSA infections occurred in the lower respiratory tract, the skin and soft tissue, and the blood. Risk factors for infection, including underlying medical illness, prior hospitalization, and prior surgery, were similar for patients with community-acquired MRSA and nosocomial MRSA. History of central venous catheterization and previous endotracheal intubation was more common in patients with nosocomial MRSA. Only 3 patients with community-acquired MRSA had no identifiable risk factor other than recent antibiotic use. Resistance for clindamycin, erythromycin, and levofloxacin was similar between strains of community-acquired MRSA and nosocomial MRSA.Conclusions:Similarities in patient risk factors and resistance patterns of isolates of both community-acquired and nosocomial MRSA suggest healthcare acquisition of most MRSA. Thus, classifying MRSA as either community acquired or nosocomial underestimates the amount of healthcare-associated MRSA.
Changing Epidemiology of Community-Onset Methicillin-Resistant Staphylococcus aureus Bacteremia
Authors: Johnson Leonard B. , Bhan Arti , Pawlak Joan , Manzor Odette , Saravolatz Louis D. 
Published: March 2006

AbstractObjectives:To review cases of community-onset Staphylococcus aureus bacteremia and to evaluate whether the risk factors and epidemiology of methicillin-resistant S. aureus (MRSA) bacteremia have changed from early reports.Design:Retrospective case-comparison study of community-onset MRSA (n - 26) and methicillin-susceptible S. aureus (MSSA) (n = 26) bacteremias at our institution.Setting:A 600-bed urban academic medical center.Patients:Twenty-six patients with community-onset MRSA bacteremia were compared with 26 patients with community-onset MSSA bacteremia. Molecular analysis was performed on S. aureus isolates from the 26 MRSA cases as well as from 13 cases of community-onset S. aureus bacteremia from 1980 and 9 cases of nosocomial S. aureus bacteremia from 2001.Results:The two groups were similar except that patients with MRSA bacteremia were more likely to have presented from a long-term-care facility (26.9% vs 4%; P = .05) and to have had multiple admissions within the preceding year (46% vs 15%; P = .03). Clamped homogeneous electric fields analysis of MRSA isolates from 1982 revealed predominantly that one clone was the epidemic strain, whereas there were 14 unique strains among current community-onset isolates. Among current nosocomial isolates, 3 patterns were identified, all of which were present in the community-onset cases.Conclusions:Previously described risk factors for MRSA acquisition may not be helpful in predicting disease due to the polyclonal spread of MRSA in the community. Unlike early outbreaks of MRSA in patients presenting from the community, current acquisition appears to be polyclonal and is usually related to contact with the healthcare system.
Prevalence of and Risk Factors for Colonization With Methicillin-ResistantStaphylococcus aureusat the Time of Hospital Admission
Authors: Jernigan John A. , Pullen Amy L. , Flowers Laura , Bell Michael , Jarvis William R. 
Published: March 2006

AbstractObjectives:To determine the prevalence of methicillin-resistantStaphylococcus aureus(MRSA) colonization among patients presenting for hospital admission and to identify risk factors for MRSA colonization.Design:Surveillance cultures were performed at the time of hospital admission to identify patients colonized with S.aureus.A case-control study was performed to identify risk factors for MRSA colonization.Setting:A tertiary-care academic medical center.Patients:Adults presenting for hospital admission (N = 974).Results:S.aureuswas isolated from 205 (21%) of the patients for whom cultures were performed. Methicillin-sensitive S.aureuswas isolated from 179 (18.4%) of the patients, and MRSA was isolated from 26 (2.7%) of the patients. All 26 MRSA-colonized patients had been admitted to a healthcare facility in the preceding year, had at least one chronic illness, or both. In multivariate analyses comparing MRSA-colonized patients with control-patients, admission to a nursing home (odds ratio [OR], 16.5; 95% confidence interval [CI95], 1.4 to 192.1;P= .025) or a hospitalization of 5 days or longer during the preceding year (OR, 3.91; CI95, 1.1 to 13.9;P= .035) were independent predictors of MRSA colonization.Conclusions:Patients colonized with MRSA admitted to this hospital likely acquired the organism during previous encounters with healthcare facilities. There was no evidence that MRSA colonization occurs commonly among low-risk individuals in this community. These data suggest that evaluation of recent healthcare exposures is essential if true community acquisition of MRSA is to be confirmed.
Community-Acquired Methicillin-Resistant Staphylococcus aureus: An Emerging Pathogen
Authors: Saïd-Salim Battolili , Mathema Barun , Kreiswirth Barry N. 
Published: March 2006

AbstractThe prevalence of MRSA in the nosocomial setting has been well studied, and its control remains a challenge for infection control professionals. Complicating this problem is the increasing number of reports on the spread of community-acquired MRSA (CA-MRSA). CA-MRSA strains differ from hospital-acquired MRSA (HA-MRSA) strains in that they are generally susceptible to most antibiotics. These strains share the presence of staphylococcal cassette chromosome mec (SCCwec) type IV in their genomes, are frequently virulent, and predominantly cause skin and soft tissue infections. The genome sequence of the prototypic CA-MRSA strain, MW2, revealed the presence of additional virulence factors not commonly present in other S. aureus strains.We determined the genetic relatedness of 30 geographically diverse CA-MRSA isolates clustered based on SCCmec type IV by sequence analysis of the polymorphic repeat region of the protein A gene (spa typing). These results indicated that most strains shared a common spa type (131), identical to MW2. Because this group tends to infect healthy individuals with no known risk factors for nosocomial acquisition of MRSA, we refer to it as CA-MRSA without risk factors. A second group, CA-MRSA with risk factors, consists of two related genotypes, spa types 1 and 7, which differ by one nucleotide change. These strains have caused severe infections in HIV-positive patients in Los Angeles and New York.Although CA-MRSA strains share genetic determinants, they are not clonal but rather are derived from different genetic backgrounds. The genetic characteristics and the epidemiology of CA-MRSA with and without risk factors are discussed.
Incidence and Prevalence of Methicillin-ResistantStaphylococcus aureusNasal Carriage Among Healthcare Workers in Geriatric Departments: Relevance to Preventive Measures
Authors: Scarnato Fabien , Mallaret Marie Reine , Croizé Jacques , Kouabenan Dongo Rémi , Dubois Michel , Maitre Anne , DeGaudemaris Régis 
Published: March 2006

AbstractMethicillin-resistantStaphylococcus aureus(MRSA) nasal carriage was assessed among healthcare workers caring for elderly patients in contact precautions in geriatric departments. Monthly incidence ranged from 0% to 3.3%. Carriage was observed only among nurses and nursing assistants. MRSA was thus infrequently acquired using precautions and carriage was usually transient.
Toxic Epidermal Necrolysis After Topical Intranasal Application of Mupirocin
Authors: Praz Sophie-Maria , de Torrenté Antoine , Zender Hervé , Schmied Edmond , Schleppy Charles-André , Genné Daniel 
Published: March 2006

AbstractWe describe a case of toxic epidermal necrolysis after intranasal application of mupirocin in a 76-year-old woman. The drug was given for eradication of methicillin-resistant Staphylococcus aureus.
Transmission of Methicillin-ResistantStaphylococcus aureusin the Neonatal Intensive Care Unit From a Patient With Community-Acquired Disease
Authors: Eckhardt Christiane , Halvosa Jesse S. , Ray Susan M. , Blumberg Henry M. 
Published: March 2006

AbstbactMethicillin-resistantStaphylococcus aureus(MRSA) has traditionally been a nosocomial pathogen. However, several recent studies have noted community-acquired MRSA among young, healthy patients with no risk factors or healthcare system exposure. We report the transmission of a strain of community-acquired MRSA in our neonatal intensive care unit.
A Pseudo-Outbreak of Vancomycin-ResistantEnterococcus faecium
Authors: Grinbaum Renato Satovschi , Guimarães Thaís , Kusano Elisa , Hosino Nair , Sader Helio , Cereda Rosangela Ferraz 
Published: March 2006

AbstractFive VRE isolates were reported from sterile samples. No infections were diagnosed among the patients, who were on different wards. PFGE showed that all five isolates were clonal. All samples were manipulated by the same worker, but the source could not be found. Contamination was probably related to manipulation of a source specimen in the laboratory.
Reducing Central Venous Catheter–Associated Primary Bloodstream Infections in Intensive Care Units Is Possible: Data From The German Nosocomial Infection Surveillance System
Authors: Zuschneid Irina , Schwab Frank , Geffers Christine , Rüden Henning , Gastmeier Petra 
Published: March 2006

AbstractBackground And Objective:The German Nosocomial Infection Surveillance System (KISS) began in 1997 as a nationwide surveillance project for voluntary registration of nosocomial infections in intensive care units (ICUs). This study investigates trends in the rates of central venous catheter (CVC)–associated primary bloodstream infections (BSIs) in ICUs since participation in KISS.Methods:Eighty-four ICUs that had participated in KISS for at least 24 months were considered for more detailed analysis. Monthly rates of primary BSI for the 84 ICUs were pooled for the 24 months. The best model for describing the curve of reduction was sought. Additionally, incidence densities were compared using the z test.Results:For the 212 ICUs participating, a relative 25.7% decrease (from 2.1 to 1.6 primary BSIs per 1,000 CVC-days) was observed from January 1997 to June 2001. The 84 ICUs that participated in KISS for a minimum of 24 months accumulated 552,359 patient-days and 404,897 CVC-days during their 24 months. A linear regression model was selected to explain the curve of primary BSI reduction in the 84 ICUs. It showed a decrease from 2.1 to 1.5 primary BSIs per 1,000 CVC-days, meaning an overall relative reduction of 28.6% during the 2-year observation period. These results were significant (Student's t test for the monthly reduction coefficient; P = .04). The reduction of primary BSIs was shown for both clinical sepsis and laboratory-confirmed, CVC-associated primary BSIs.Conclusion:Performing surveillance with KISS was associated with a reduction of the rates of CVC-associated primary BSIs in ICU patients (Infect Control Hosp Epidemiol 2003;24:501-505).
Reported Measures of Hygiene and Incidence Rates for Hospital-Acquired Diarrhea in 31 French Pediatric Wards: Is There Any Relationship?
Authors: Jusot Jean-François , Vanhems Philippe , Benzait Fatima , Berthelot Philippe , Patural Hugues , Teyssier Georges , Fabry Jacques , Pozzetto Bruno 
Published: March 2006

AbstractObjective:To investigate the relationship between hygienic measures reported for the prevention of hospital-acquired diarrhea and incidence rates of hospital-acquired diarrhea.Design:A survey of hospital-acquired diarrhea was conducted between January 1 and March 31, 1999. Multivariate analysis of reported measures of hygiene according to the observed incidence rates of hospital-acquired diarrhea was performed.Setting:Thirty-one pediatric or neonatal wards located in hospitals in the southeast of France, selected as a convenience sample of wards volunteering to participate.Patients:A total of 6,726 children younger than 5 years.Results:The overall incidence rate of hospital-acquired diarrhea was 3.6%. Rotavirus was responsible for 69% of the cases of hospital-acquired diarrhea. Among the hygienic measures reported by the wards for preventing hospital-acquired diarrhea were using a single room or cohorting (77.4%), washing hands (83.9%), wearing gowns (80.6%), and wearing disposable single-use gloves for diapering a patient (51.6%). By multivariate analysis, the variables statistically associated with a lower incidence of hospital-acquired diarrhea were restricting the patient's mobility outside his or her room, keeping the patient's door closed, and having fewer than 20 beds in the ward, with adjusted odds ratios of 0.34 (95% confidence interval [CL95], 0.18 to 0.65), 0.33 (CI95, 0.23 to 0.47), and 0.42 (CI95, 0.30 to 0.60), respectively.Conclusion:Simple preventive measures can decrease the rate of hospital-acquired diarrhea in pediatric wards (Infect Control Hosp Epidemiol 2003;24:520-525)
Influence of Building Construction Work On Aspergillus Infection in a Hospital Setting
Authors: Cooper E. E. , O'Reilly M. A. , Guest D. I. , Dharmage S. C. 
Published: March 2006

AbstractBackground And Objective:Aspergillus fumigatus is a major pathogen causing nosocomial infections. Hospital outbreaks of invasive aspergillosis have been associated with the renovation and construction of buildings. Building construction work for fire safety upgrading was undertaken during a 16-week period in 2001 at Box Hill Hospital. This study was designed to examine the effect of construction on invasive aspergillosis when using standard and additional protective measures.Methods:Baseline air sampling was conducted in 18 areas. The validity of the air sampling was assessed by comparing the ability of two air samplers to detect Aspergillus conidia. Surveillance of nosocomial Aspergillus infection was conducted by reviewing the records of patients with a sputum culture positive for Aspergillus and those prescribed amphotericin or itraconazole for the period of construction activity and the same period the previous year.Results:Aspergillus was isolated infrequently and there was no statistically significant difference in the levels of viable pathogenic fungi between areas where construction work was undertaken and areas where it was not undertaken. A moderate agreement was observed between the two air samplers (kappa = 0.4; P < .05). There was no difference in the incidence of invasive aspergillosis between 2000 and 2001 (incidence density ratio, 1.2; 95% confidence interval, 0.3 to 4.1).Conclusion:The influence of construction work performed with protective measures needs to be examined in an environment with higher levels of airborne fungi to confirm the findings of this study (Infect Control Hosp Epidemiol 2003;24:472-476).