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Godijk NG, Bootsma MCJ, Bonten MJM. Transmission routes of antibiotic resistant bacteria: a systematic review. BMC Infect Dis 2022; 22:482. [PMID: 35596134 PMCID: PMC9123679 DOI: 10.1186/s12879-022-07360-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background Quantification of acquisition routes of antibiotic resistant bacteria (ARB) is pivotal for understanding transmission dynamics and designing cost-effective interventions. Different methods have been used to quantify the importance of transmission routes, such as relative risks, odds ratios (OR), genomic comparisons and basic reproduction numbers. We systematically reviewed reported estimates on acquisition routes’ contributions of ARB in humans, animals, water and the environment and assessed the methods used to quantify the importance of transmission routes. Methods PubMed and EMBASE were searched, resulting in 6054 articles published up until January 1st, 2019. Full text screening was performed on 525 articles and 277 are included. Results We extracted 718 estimates with S. aureus (n = 273), E. coli (n = 157) and Enterobacteriaceae (n = 99) being studied most frequently. Most estimates were derived from statistical methods (n = 560), mainly expressed as risks (n = 246) and ORs (n = 239), followed by genetic comparisons (n = 85), modelling (n = 62) and dosage of ARB ingested (n = 17). Transmission routes analysed most frequently were occupational exposure (n = 157), travelling (n = 110) and contacts with carriers (n = 83). Studies were mostly performed in the United States (n = 142), the Netherlands (n = 87) and Germany (n = 60). Comparison of methods was not possible as studies using different methods to estimate the same route were lacking. Due to study heterogeneity not all estimates by the same method could be pooled. Conclusion Despite an abundance of published data the relative importance of transmission routes of ARB has not been accurately quantified. Links between exposure and acquisition are often present, but the frequency of exposure is missing, which disables estimation of transmission routes’ importance. To create effective policies reducing ARB, estimates of transmission should be weighed by the frequency of exposure occurrence. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07360-z.
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Affiliation(s)
- Noortje G Godijk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Martin C J Bootsma
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Mathematics, Faculty of Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marc J M Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Genomic Update of Phenotypic Prediction Rule for Methicillin-Resistant Staphylococcus aureus (MRSA) USA300 Discloses Jail Transmission Networks with Increased Resistance. Microbiol Spectr 2021; 9:e0037621. [PMID: 34287060 PMCID: PMC8552710 DOI: 10.1128/spectrum.00376-21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of health care-associated (HA) and community-associated (CA) infections. USA300 strains are historically CA-MRSA, while USA100 strains are HA-MRSA. Here, we update an antibiotic prediction rule to distinguish these two genotypes based on antibiotic resistance phenotype using whole-genome sequencing (WGS), a more discriminatory methodology than pulsed-field gel electrophoresis (PFGE). MRSA clinical isolates collected from 2007 to 2017 underwent WGS; associated epidemiologic data were ascertained. In developing the rule, we examined MRSA isolates that included a population with a history of incarceration. Performance characteristics of antibiotic susceptibility for predicting USA300 compared to USA100, as defined by WGS, were examined. Phylogenetic analysis was performed to examine resistant USA300 clades. We identified 275 isolates (221 USA300, 54 USA100). Combination susceptibility to clindamycin or levofloxacin performed the best overall (sensitivity 80.7%, specificity 75.9%) to identify USA300. The average number of antibiotic classes with resistance was higher for USA100 (3 versus 2, P < 0.001). Resistance to ≤2 classes was predictive for USA300 (area under the curve (AUC) 0.84, 95% confidence interval 0.78 to 0.90). Phylogenetic analysis identified a cluster of USA300 strains characterized by increased resistance among incarcerated individuals. Using a combination of clindamycin or levofloxacin susceptibility, or resistance to ≤2 antibiotic classes, was predictive of USA300 as defined by WGS. Increased resistance was observed among individuals with incarceration exposure, suggesting circulation of a more resistant USA300 clade among at-risk community networks. Our phenotypic prediction rule could be used as an epidemiologic tool to describe community and nosocomial shifts in USA300 MRSA and quickly identify emergence of lineages with increased resistance. IMPORTANCE Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of health care-associated (HA) and community-associated (CA) infections, but the epidemiology of these strains (USA100 and USA300, respectively) now overlaps in health care settings. Although sequencing technology has become more available, many health care facilities still lack the capabilities to perform these analyses. In this study, we update a simple prediction rule based on antibiotic resistance phenotype with integration of whole-genome sequencing (WGS) to predict strain type based on antibiotic resistance profiles that can be used in settings without access to molecular strain typing methods. This prediction rule has many potential epidemiologic applications, such as analysis of retrospective data sets, regional monitoring, and ongoing surveillance of CA-MRSA infection trends. We demonstrate application of this rule to identify an emerging USA300 strain with increased antibiotic resistance among incarcerated individuals that deviates from the rule.
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3
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Hogan PG, Mork RL, Thompson RM, Muenks CE, Boyle MG, Sullivan ML, Morelli JJ, Williams CV, Sanchez N, Hunstad DA, Wardenburg JB, Gehlert SJ, Burnham CAD, Rzhetsky A, Fritz SA. Environmental Methicillin-resistant Staphylococcus aureus Contamination, Persistent Colonization, and Subsequent Skin and Soft Tissue Infection. JAMA Pediatr 2020; 174:552-562. [PMID: 32227144 PMCID: PMC7105954 DOI: 10.1001/jamapediatrics.2020.0132] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
IMPORTANCE The longitudinal association among persistent Staphylococcus aureus colonization, household environmental contamination, and recurrent skin and soft tissue infection (SSTI) is largely unexplored to date. OBJECTIVES To identify factors associated with persistent S aureus colonization and recurrent SSTI in households with children with community-associated methicillin-resistant S aureus (MRSA) SSTI. DESIGN, SETTING, AND PARTICIPANTS This 12-month prospective cohort study included 150 children with community-associated MRSA SSTI, 542 household contacts, and 154 pets enrolled from January 3, 2012, through October 20, 2015. A total of 5 quarterly home visits were made to 150 households in the St Louis, Missouri, region. Statistical analysis was performed from September 18, 2018, to January 7, 2020. EXPOSURES Covariates used in S aureus strain persistence and interval SSTI models included S aureus colonization and contamination measures, personal hygiene and sharing habits, health history, activities external to the home, and household characteristics (eg, cleanliness, crowding, home ownership, and pets). Serial samples to detect S aureus were collected from household members at 3 anatomic sites, from pets at 2 anatomic sites, and from environmental surfaces at 21 sites. MAIN OUTCOMES AND MEASURES Molecular epidemiologic findings of S aureus isolates were assessed via repetitive-sequence polymerase chain reaction. Individual persistent colonization was defined as colonization by an identical strain for 2 consecutive samplings. Longitudinal, multivariable generalized mixed-effects logistic regression models were used to assess factors associated with persistent S aureus personal colonization, environmental contamination, and interval SSTI. RESULTS Among 692 household members in 150 households, 326 (47%) were male and 366 (53%) were female, with a median age of 14.82 years (range, 0.05-82.25 years). Of 540 participants completing all 5 samplings, 213 (39%) were persistently colonized with S aureus, most often in the nares and with the strain infecting the index patient at enrollment. Nine pets (8%) were persistently colonized with S aureus. Participants reporting interval intranasal mupirocin application were less likely to experience persistent colonization (odds ratio [OR], 0.44; 95% credible interval [CrI], 0.30-0.66), whereas increasing strain-specific environmental contamination pressure was associated with increased individual persistent colonization (OR, 1.17; 95% CrI, 1.06-1.30). Strains with higher colonization pressure (OR, 1.47; 95% CrI, 1.25-1.71) and MRSA strains (OR, 1.57; 95% CrI, 1.16-2.19) were more likely to persist. Seventy-six index patients (53%) and 101 household contacts (19%) reported interval SSTIs. Individuals persistently colonized with MRSA (OR, 1.56; 95% CrI, 1.17-2.11), those with a history of SSTI (OR, 2.55; 95% CrI, 1.88-3.47), and index patients (OR, 1.54; 95% CrI, 1.07-2.23) were more likely to report an interval SSTI. CONCLUSIONS AND RELEVANCE The study findings suggest that recurrent SSTI is associated with persistent MRSA colonization of household members and contamination of environmental surfaces. Future studies may elucidate the effectiveness of specific combinations of personal decolonization and environmental decontamination efforts in eradicating persistent strains and mitigating recurrent SSTIs.
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Affiliation(s)
- Patrick G. Hogan
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Ryan L. Mork
- Graduate Program in the Biophysical Sciences, University of Chicago, Chicago, Illinois,Committee of Microbiology, University of Chicago, Chicago, Illinois,Institute for Genomics and Systems Biology, University of Chicago, Chicago, Illinois
| | - Ryley M. Thompson
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Carol E. Muenks
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Mary G. Boyle
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Melanie L. Sullivan
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - John J. Morelli
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Caroline V. Williams
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Nataly Sanchez
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - David A. Hunstad
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri,Department of Molecular Microbiology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | | | - Sarah J. Gehlert
- Department of Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Carey-Ann D. Burnham
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri,Department of Molecular Microbiology, Washington University School of Medicine in St Louis, St Louis, Missouri,Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, Missouri,Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Andrey Rzhetsky
- Department of Human Genetics, University of Chicago, Chicago, Illinois
| | - Stephanie A. Fritz
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
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Davis MF, McCormack MC, Matsui EC. Growing Concerns with Staphylococcus aureus and Asthma: New Territory for an Old Foe? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 7:616-617. [PMID: 30717872 DOI: 10.1016/j.jaip.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 10/03/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Meghan F Davis
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; Johns Hopkins School of Medicine, Baltimore, Md.
| | - Meredith C McCormack
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; Johns Hopkins School of Medicine, Baltimore, Md
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5
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Shoen HRC, Rose SJ, Ramsey SA, de Morais H, Bermudez LE. Analysis of Staphylococcus infections in a veterinary teaching hospital from 2012 to 2015. Comp Immunol Microbiol Infect Dis 2019; 66:101332. [PMID: 31437674 DOI: 10.1016/j.cimid.2019.101332] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 06/27/2019] [Accepted: 07/10/2019] [Indexed: 11/16/2022]
Abstract
Records of all Diagnostic laboratory submissions from 2012 to 2015 were examined and subjected to analysis according to species, location of infection, species of bacteria, and antibiotic resistance/susceptibility. A total of 23.8% of all culture isolates were Staphylococcus sp. Of those Staphylococcus, 43% were isolated from surgical site infections. Staphylococcus pseudintermedius accounted for approximately 28% of all staphylococcus cultures, while methicillin-resistant (MR) S. pseudintermedius accounted for 8% of all staphylococcus cultures. Environmental samples were also collected by swabbing surfaces in the intensive care unit (ICU) and anesthesia prep room at the OSU VTH. Isolated bacterial colonies were subjected to PCR for species identification and for the presence of the mecA gene. Ability of horizontal transfer in vitro of the mecA gene was evaluated by incubating the mecA positive bacterium, with the mecA negative bacterium, and then plated onto agar plates infused with known concentration of oxacillin. Colonies were then subjected to PCR for species and mecA identification. Horizontal transfer of the mecA gene was demonstrated and confirmed via PCR from MR S. epidermidis to MS S. pseudintermedius in an in vitro model that mimicked the veterinary hospital environment. Biofilms were established using four Staphylococcus species isolated from swabbing the Intensive Care Unit (ICU) and anesthesia prep room and were resistant when exposed to the current cleaning agent. Staphylococcus species makeup nearly ¼ of all infections at OSU VDL during the four years of the study, and MS S. pseudintermedius was shown to acquire the mecA gene from an environmental strain.
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Affiliation(s)
- Hanna R C Shoen
- Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, United States
| | - Sasha J Rose
- Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, United States
| | - Stephen A Ramsey
- Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, United States; School of Electrical Engineering and Computer Science, College of Engineering, United States
| | - Helio de Morais
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, United States
| | - Luiz E Bermudez
- Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, United States; Department of Microbiology, College of Science, Oregon State University, Corvallis, OR, United States.
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6
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Henderson A, Nimmo GR. Control of healthcare- and community-associated MRSA: recent progress and persisting challenges. Br Med Bull 2018; 125:25-41. [PMID: 29190327 DOI: 10.1093/bmb/ldx046] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/31/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Healthcare adapted meticillin-resistant Staphylococcus aureus (MRSA) has spread to hospitals around the world over 50 years. More recently, other strains of MRSA have emerged with the ability to spread in the community and infect otherwise healthy individuals. Morbidity and mortality associated with MRSA remains high and its control in both the healthcare and community setting has proven challenging. SOURCES OF DATA Pubmed (Medline). AREAS OF AGREEMENT The use of targeted screening and decolonization, hand hygiene and antimicrobial stewardship is supported by the most robust studies, though many studies have implemented bundles for effective healthcare-associated (HA)-MRSA control. AREAS OF CONTENTION Universal screening, universal decolonization and contact precautions for HA-MRSA control are supported by less evidence. Some interventions may not be cost-effective. Contact precautions may be associated with potential for patient harm. Evidence for effective control community acquired (CA)-MRSA is largely lacking. GROWING POINTS Programmes that focus on implementing bundles of interventions aimed at targeting HA-MRSA are more likely to be effective, with an emphasis on hand hygiene as a key component. Control of CA-MRSA is likely to be more difficult to achieve and relies on prevalence, risk factors and community healthcare interactions on a broader scale. AREAS TIMELY FOR DEVELOPING RESEARCH Further research in the area of CA-MRSA in particular is required. Antimicrobial stewardship for both CA and HA-MRSA is promising, as is the role of whole genome sequencing in characterizing transmission. However, further work is required to assess their long-term roles in controlling MRSA. With many institutions applying widespread use of chlorhexidine washes, monitoring for chlorhexidine resistance is paramount to sustaining efforts at controlling MRSA.
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Affiliation(s)
- Andrew Henderson
- Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Queensland 4102, Australia.,School of Chemistry and Molecular Biosciences, University of Queensland, St Lucia, Queensland 4067, Australia.,University of Queensland Centre for Clinical Research, Herston, Queensland 4029, Australia
| | - Graeme R Nimmo
- Pathology Queensland Central Laboratory, Herston, Queensland 4029, Australia.,School of Medicine, Griffith University, Southport 4222, Queensland, Australia
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8
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Hogan PG, Rodriguez M, Spenner AM, Brenneisen JM, Boyle MG, Sullivan ML, Fritz SA. Impact of Systemic Antibiotics on Staphylococcus aureus Colonization and Recurrent Skin Infection. Clin Infect Dis 2018; 66:191-197. [PMID: 29020285 PMCID: PMC5850557 DOI: 10.1093/cid/cix754] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 08/21/2017] [Indexed: 12/21/2022] Open
Abstract
Background Staphylococcus aureus colonization poses risk for subsequent skin and soft tissue infection (SSTI). We hypothesized that including systemic antibiotics in the management of S. aureus SSTI, in conjunction with incision and drainage, would reduce S. aureus colonization and incidence of recurrent infection. Methods We prospectively evaluated 383 children with S. aureus SSTI requiring incision and drainage and S. aureus colonization in the anterior nares, axillae, or inguinal folds at baseline screening. Systemic antibiotic prescribing at the point of care was recorded. Repeat colonization sampling was performed within 3 months (median, 38 days; interquartile range, 22-50 days) in 357 participants. Incidence of recurrent infection was ascertained for up to 1 year. Results Participants prescribed guideline-recommended empiric antibiotics for purulent SSTI were less likely to remain colonized at follow-up sampling (adjusted hazard ratio [aHR], 0.49; 95% confidence interval [CI], .30-.79) and less likely to have recurrent SSTI (aHR, 0.57; 95% CI, .34-.94) than those not receiving guideline-recommended empiric antibiotics for their SSTI. Additionally, participants remaining colonized at repeat sampling were more likely to report a recurrent infection over 12 months (aHR, 2.37; 95% CI, 1.69-3.31). Clindamycin was more effective than trimethoprim-sulfamethoxazole (TMP-SMX) in eradicating S. aureus colonization (44% vs 57% remained colonized, P = .03) and preventing recurrent SSTI (31% vs 47% experienced recurrence, P = .008). Conclusions Systemic antibiotics, as part of acute SSTI management, impact S. aureus colonization, contributing to a decreased incidence of recurrent SSTI. The mechanism by which clindamycin differentially affects colonization and recurrent SSTI compared to TMP-SMX warrants further study.
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Affiliation(s)
- Patrick G Hogan
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Marcela Rodriguez
- Department of Pediatrics, Southern Illinois University School of Medicine, Springfield
| | - Allison M Spenner
- Department of Pediatrics, Southern Illinois University School of Medicine, Springfield
| | - Jennifer M Brenneisen
- Department of Pediatrics, Southern Illinois University School of Medicine, Springfield
| | - Mary G Boyle
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Melanie L Sullivan
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Stephanie A Fritz
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
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10
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CLUZET VC, GERBER JS, NACHAMKIN I, COFFIN SE, DAVIS MF, JULIAN KG, ZAOUTIS TE, METLAY JP, LINKIN DR, TOLOMEO P, WISE JA, BILKER WB, HU B, LAUTENBACH E. Factors associated with persistent colonisation with methicillin-resistant Staphylococcus aureus. Epidemiol Infect 2017; 145:1409-1417. [PMID: 28219463 PMCID: PMC9203296 DOI: 10.1017/s0950268817000012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 11/26/2016] [Accepted: 12/30/2016] [Indexed: 12/12/2022] Open
Abstract
We conducted a prospective cohort study between 1 January 2010 and 31 December 2012 at five adult and paediatric academic medical centres to identify factors associated with persistent methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Adults and children presenting to ambulatory settings with a MRSA skin and soft tissue infection (i.e. index cases), along with household members, performed self-sampling for MRSA colonisation every 2 weeks for 6 months. Clearance of colonisation was defined as two consecutive negative sampling periods. Subjects without clearance by the end of the study were considered persistently colonised and compared with those who cleared colonisation. Of 243 index cases, 48 (19·8%) had persistent colonisation and 110 (45·3%) cleared colonisation without recurrence. Persistent colonisation was associated with white race (odds ratio (OR), 4·90; 95% confidence interval (CI), 1·38-17·40), prior MRSA infection (OR 3·59; 95% CI 1·05-12·35), colonisation of multiple sites (OR 32·7; 95% CI 6·7-159·3). Conversely, subjects with persistent colonisation were less likely to have been treated with clindamycin (OR 0·28; 95% CI 0·08-0·99). Colonisation at multiple sites is a risk factor for persistent colonisation and may require more targeted decolonisation efforts. The specific effect of clindamycin on MRSA colonisation needs to be elucidated.
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Affiliation(s)
- V. C. CLUZET
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - J. S. GERBER
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Division of Infectious Diseases, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, USA
| | - I. NACHAMKIN
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - S. E. COFFIN
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Division of Infectious Diseases, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, USA
| | - M. F. DAVIS
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - K. G. JULIAN
- Division of Infectious Diseases, Penn State Hershey Medical Center, Hershey, USA
| | - T. E. ZAOUTIS
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Division of Infectious Diseases, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, USA
| | - J. P. METLAY
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - D. R. LINKIN
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - P. TOLOMEO
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - J. A. WISE
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - W. B. BILKER
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - B. HU
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - E. LAUTENBACH
- Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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11
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Focus on optimization of early antimicrobial therapy in ICU-acquired infections. Intensive Care Med 2016; 42:1658-1660. [DOI: 10.1007/s00134-016-4485-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
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12
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Gase KA, Reese SM. Journal Club: Impact of rapid screening for discontinuation of methicillin-resistant Staphylococcus aureus contact precautions. Am J Infect Control 2016; 44:475-6. [PMID: 26804307 DOI: 10.1016/j.ajic.2015.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 11/09/2015] [Indexed: 11/15/2022]
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13
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Davis MF, Misic AM, Morris DO, Moss JT, Tolomeo P, Beiting DP, Nachamkin I, Lautenbach E, Rankin SC. Genome sequencing reveals strain dynamics of methicillin-resistant Staphylococcus aureus in the same household in the context of clinical disease in a person and a dog. Vet Microbiol 2015; 180:304-7. [PMID: 26411322 DOI: 10.1016/j.vetmic.2015.09.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 09/09/2015] [Accepted: 09/15/2015] [Indexed: 12/21/2022]
Abstract
The strain dynamics of methicillin-resistant Staphylococcus aureus (MRSA) isolates from people and the household dog were investigated. The isolates were identified in the context of a randomized controlled trial that tested household-wide decolonization of people. Genotypic comparison of MRSA isolates obtained from two household members, the dog, and home surfaces over a three-month period failed to implicate the pet or the home environment in recurrent colonization of the household members. However, it did implicate the pet's bed in exposure of the dog prior to the dog's infection. Whole genome sequencing was performed to differentiate the isolates. This report also describes introduction of diverse strains of MRSA into the household within six weeks of cessation of harmonized decolonization treatment of people and treatment for infection in the dog. These findings suggest that community sources outside the home may be important for recurrent MRSA colonization or infection.
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Affiliation(s)
- Meghan F Davis
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Ana M Misic
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, Pennsylvania 19104, USA
| | - Daniel O Morris
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, Pennsylvania 19104, USA
| | - John T Moss
- Brandywine Valley Veterinary Hospital, 2580 Strasburg Rd., Coatesville, PA 19320, USA
| | - Pam Tolomeo
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Bldging 421, Philadelphia, 19104, USA
| | - Daniel P Beiting
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, Pennsylvania 19104, USA
| | - Irving Nachamkin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Bldging 421, Philadelphia, 19104, USA
| | - Ebbing Lautenbach
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Bldging 421, Philadelphia, 19104, USA
| | - Shelley C Rankin
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, Pennsylvania 19104, USA
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