MRSA Studies Highlight Importance of Infection Control

CHICAGO — Transitional care facilities may need to consider placing incoming surgical patients in private rooms to prevent the transmission of methicillin-resistant Staphylococcus aureus, according to a poster study presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy.

The study, conducted at the MeritCare Medical Center in Fargo, N.D., revealed that methicillin-resistant S. aureus (MRSA) nasal colonization was 1.6%, which is double the national estimate reported for 2001–2002 (J. Infect. Dis. 2006;193:172–9).

The MeritCare Medical Center is a private hospital that serves as a “step-down” facility for patients awaiting nursing home placement, said Stephanie M. Borchardt, Ph.D., of the Fargo Veterans Affairs Medical Center.

Swab specimens were collected from the anterior nares of 550 transitional care unit (TCU) patients between September 2003 and November 2004. “These were older patients, most of whom were coming off a surgical service, and [they] were significantly more likely than others to be colonized with MRSA,” she said.

The median patient age was 78 years, and 64% were female. Of those positive for MRSA, more than half were being cared for by orthopedic surgery service at the time, one-third were on the cardiology or cardiothoracic surgery service, and 11% were on the general surgery service, the authors reported at a meeting sponsored by the American Society for Microbiology.

“These findings highlight the need to consider lodging surgical patients in private TCU patient rooms to prevent transmission of MRSA,” Dr. Borchardt said.

A second surveillance culture study found high rates of both MRSA and Acinetobacter baumannii colonization in patients at a long-term acute-care facility in Baltimore. Nose, perirectal, sputum, and wound cultures were collected from 35 patients; cultures were retrieved from one or more of those sites in an additional 114 patients, said Jon P. Furuno, Ph.D.

The prevalence of MRSA was 30% and of A. baumannii, 28%, said Dr. Furuno of the University of Maryland, College Park.

Anterior nares and sputum cultures were the most sensitive in identifying MRSA and A. baumannii respectively, and most A. baumannii were susceptible to ampicillin/sulbactam (93%), imipenem (90%), amikacin (80%), or trimethoprim/sulfamethoxazole (30%).

It was not surprising that over a quarter of the cultures were positive, because most of the patients in the Baltimore facility are in poor condition and have been at high risk of pathogen exposure, Dr. Furuno said in an interview.

“If a large portion of your patients are transferred from facilities where they might pick up these organisms, it's important that you have a team-based infection control system in place and that you assess the overall burden of colonization in these patients,” he concluded.

CHICAGO — Transitional care facilities may need to consider placing incoming surgical patients in private rooms to prevent the transmission of methicillin-resistant Staphylococcus aureus, according to a poster study presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy.

The study, conducted at the MeritCare Medical Center in Fargo, N.D., revealed that methicillin-resistant S. aureus (MRSA) nasal colonization was 1.6%, which is double the national estimate reported for 2001–2002 (J. Infect. Dis. 2006;193:172–9).

The MeritCare Medical Center is a private hospital that serves as a “step-down” facility for patients awaiting nursing home placement, said Stephanie M. Borchardt, Ph.D., of the Fargo Veterans Affairs Medical Center.

Swab specimens were collected from the anterior nares of 550 transitional care unit (TCU) patients between September 2003 and November 2004. “These were older patients, most of whom were coming off a surgical service, and [they] were significantly more likely than others to be colonized with MRSA,” she said.

The median patient age was 78 years, and 64% were female. Of those positive for MRSA, more than half were being cared for by orthopedic surgery service at the time, one-third were on the cardiology or cardiothoracic surgery service, and 11% were on the general surgery service, the authors reported at a meeting sponsored by the American Society for Microbiology.

“These findings highlight the need to consider lodging surgical patients in private TCU patient rooms to prevent transmission of MRSA,” Dr. Borchardt said.

A second surveillance culture study found high rates of both MRSA and Acinetobacter baumannii colonization in patients at a long-term acute-care facility in Baltimore. Nose, perirectal, sputum, and wound cultures were collected from 35 patients; cultures were retrieved from one or more of those sites in an additional 114 patients, said Jon P. Furuno, Ph.D.

The prevalence of MRSA was 30% and of A. baumannii, 28%, said Dr. Furuno of the University of Maryland, College Park.

Anterior nares and sputum cultures were the most sensitive in identifying MRSA and A. baumannii respectively, and most A. baumannii were susceptible to ampicillin/sulbactam (93%), imipenem (90%), amikacin (80%), or trimethoprim/sulfamethoxazole (30%).

It was not surprising that over a quarter of the cultures were positive, because most of the patients in the Baltimore facility are in poor condition and have been at high risk of pathogen exposure, Dr. Furuno said in an interview.

“If a large portion of your patients are transferred from facilities where they might pick up these organisms, it's important that you have a team-based infection control system in place and that you assess the overall burden of colonization in these patients,” he concluded.

CHICAGO — Transitional care facilities may need to consider placing incoming surgical patients in private rooms to prevent the transmission of methicillin-resistant Staphylococcus aureus, according to a poster study presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy.

The study, conducted at the MeritCare Medical Center in Fargo, N.D., revealed that methicillin-resistant S. aureus (MRSA) nasal colonization was 1.6%, which is double the national estimate reported for 2001–2002 (J. Infect. Dis. 2006;193:172–9).

The MeritCare Medical Center is a private hospital that serves as a “step-down” facility for patients awaiting nursing home placement, said Stephanie M. Borchardt, Ph.D., of the Fargo Veterans Affairs Medical Center.

Swab specimens were collected from the anterior nares of 550 transitional care unit (TCU) patients between September 2003 and November 2004. “These were older patients, most of whom were coming off a surgical service, and [they] were significantly more likely than others to be colonized with MRSA,” she said.

The median patient age was 78 years, and 64% were female. Of those positive for MRSA, more than half were being cared for by orthopedic surgery service at the time, one-third were on the cardiology or cardiothoracic surgery service, and 11% were on the general surgery service, the authors reported at a meeting sponsored by the American Society for Microbiology.

“These findings highlight the need to consider lodging surgical patients in private TCU patient rooms to prevent transmission of MRSA,” Dr. Borchardt said.

A second surveillance culture study found high rates of both MRSA and Acinetobacter baumannii colonization in patients at a long-term acute-care facility in Baltimore. Nose, perirectal, sputum, and wound cultures were collected from 35 patients; cultures were retrieved from one or more of those sites in an additional 114 patients, said Jon P. Furuno, Ph.D.

The prevalence of MRSA was 30% and of A. baumannii, 28%, said Dr. Furuno of the University of Maryland, College Park.

Anterior nares and sputum cultures were the most sensitive in identifying MRSA and A. baumannii respectively, and most A. baumannii were susceptible to ampicillin/sulbactam (93%), imipenem (90%), amikacin (80%), or trimethoprim/sulfamethoxazole (30%).

It was not surprising that over a quarter of the cultures were positive, because most of the patients in the Baltimore facility are in poor condition and have been at high risk of pathogen exposure, Dr. Furuno said in an interview.

“If a large portion of your patients are transferred from facilities where they might pick up these organisms, it's important that you have a team-based infection control system in place and that you assess the overall burden of colonization in these patients,” he concluded.