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Community-Acquired Infection With Healthcare-Associated Methicillin-Resistant Staphylococcus aureus: The Role of Home Nursing Care

Published online by Cambridge University Press:  21 June 2016

François-Xavier Lescure ,
Gwenaelle Locher ,
Mathieu Eveillard ,
Maurice Biendo ,
Stéphanie Van Agt ,
Guillaume Le Loup ,
Youcef Douadi ,
Olivier Ganry ,
François Vandenesch  and
François Eb
...Show all authors
François-Xavier Lescure*
Affiliation:
Departments of Tropical and Infectious Diseases, Hospital and University Centre, Amiens, France Service de maladies infectieuses et tropicales, Hôpital Tenon, Paris, France
Gwenaelle Locher
Affiliation:
Bacteriology, Hospital and University Centre, Amiens, France
Mathieu Eveillard
Affiliation:
Bacteriology, Hospital and University Centre, Amiens, France
Maurice Biendo
Affiliation:
Bacteriology, Hospital and University Centre, Amiens, France
Stéphanie Van Agt
Affiliation:
Bacteriology, Hospital and University Centre, Amiens, France
Guillaume Le Loup
Affiliation:
Departments of Tropical and Infectious Diseases, Hospital and University Centre, Amiens, France
Youcef Douadi
Affiliation:
Departments of Tropical and Infectious Diseases, Hospital and University Centre, Amiens, France
Olivier Ganry
Affiliation:
Epidemiology, Hospital and University Centre, Amiens, France
François Vandenesch
Affiliation:
INSERM E0230, IFR62, Centre National de Référence des Staphylocoques, Faculté de Médecine Laennec, Lyon, France
François Eb
Affiliation:
Bacteriology, Hospital and University Centre, Amiens, France
Jean-Luc Schmit
Affiliation:
Departments of Tropical and Infectious Diseases, Hospital and University Centre, Amiens, France
Jerome Etienne
Affiliation:
INSERM E0230, IFR62, Centre National de Référence des Staphylocoques, Faculté de Médecine Laennec, Lyon, France
*
Service de maladies infectieuses et tropicales, Hôpital Tenon, Assistance publique des hôpitaux de Paris (ap-hp), 4 rue de la Chine, 75970 Paris cedex 20, France ([email protected])
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Abstract

Objective.

To better understand the role of indirect transmission in community-acquired infection with methicillin-resistant Staphylococcus aureus (MRSA).

Design.

Prospective case-control study.

Setting.

A French teaching hospital.

Patients.

A total of 198 case patients and 198 control patients with MRSA or methicillin-susceptible S. aureus infection diagnosed between April 2002 and July 2003.

Results.

Multivariate analysis showed a highly significant independent link between MRSA infection at admission and prior receipt of home nursing care (odds ratio [OR], 3.7; P<.001). Other independent risk factors were prior hospitalization (OR, 3.8; P<.001), transfer from another institution (OR, 2.3; P = .008), and age older than 65 years (OR, 1.6; P = .04). Prior home nursing care showed a frequency dose-response relationship. Eleven MRSA-infected patients had had home nursing procedures but no hospital stay in the previous 3 years. These patients' MRSA strains were related to the prevalent MRSA clone currently spreading in French hospitals.

Conclusion.

Home nursing care appears to be an independent risk factor for MRSA acquisition in the community. The reservoir probably consists of MRSA carriers discharged from the hospital. Community nurses seem to be a potential vector.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 11 , November 2006 , pp. 1213 - 1218
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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References

1. Tiemersma, EW, Bronzwaer, SL, Lyytikainen, O, et al. Methicillin-resistant Staphylococcus aureus in Europe, 1999-2002. Emerg Infect Dis 2004; 10:1627–1634.Google Scholar
2. Heym, B, Le Moal, M, Armand-Lefevre, L, Nicolas-Chanoine, MH. Multilocus sequence typing (MLST) shows that the ‘Iberian’ clone of methicillin-resistant Staphylococcus aureus has spread to France and acquired reduced susceptibility to teicoplanin. J Antimicrob Chemother 2002; 50:323–329.CrossRefGoogle ScholarPubMed
3. Oliveira, DC, Tomasz, A, de Lencastre, H. Secrets of success of a human pathogen: molecular evolution of pandemic clones of methicillin-resistant Staphylococcus aureus . Lancet Infect Dis 2002; 2:180–189.Google Scholar
4. Vandenesch, F, Naimi, T, Enright, MC, et al. Community-acquired methicillin-resistant Staphylococcus aureus carrying Panton-Valentine leukocidin genes: worldwide emergence. Emerg Infect Dis 2003; 9:978–984.CrossRefGoogle ScholarPubMed
5. Francis, JS, Doherty, MC, Lopatin, U, et al. Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes. Clin Infect Dis 2005; 40:100–107.Google Scholar
6. Naimi, TS, LeDell, KH, Como-Sabetti, K, et al. Comparison of community-and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA 2003; 290:2976–2984.Google Scholar
7. Salgado, CD, Farr, BM, Calfee, DP. Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin Infect Dis 2003; 36:131–139.CrossRefGoogle ScholarPubMed
8. Charlebois, ED, Bangsberg, DR, Moss, NJ, et al. Population-based community prevalence of methicillin-resistant Staphylococcus aureus in the urban poor of San Francisco. Clin Infect Dis 2002; 34:425–433.Google Scholar
9. Abudu, L, Blair, I, Fraise, A, Cheng, KK. Methicillin-resistant Staphylococcus aureus (MRSA): a community-based prevalence survey. Epidemiol Infect 2001; 126:351–356.CrossRefGoogle ScholarPubMed
10. Hussain, FM, Boyle-Vavra, S, Bethel, CD, Daum, RS. Current trends in community-acquired methicillin-resistant Staphylococcus aureus at a tertiary care pediatric facility. Pediatr Infect Dis J 2000; 19:1163–1166.Google Scholar
11. Rezende, NA, Blumberg, HM, Metzger, BS, Larsen, NM, Ray, SM, McGowan, JE Jr. Risk factors for methicillin-resistance among patients with Staphylococcus aureus bacteremia at the time of hospital admission. Am J Med Sci 2002; 323:117–123.Google Scholar
12. Troillet, N, Carmeli, Y, Samore, MH, et al. Carriage of methicillin-resistant Staphylococcus aureus at hospital admission. Infect Control Hosp Epidemiol 1998; 19:181–185.CrossRefGoogle ScholarPubMed
13. Shopsin, B, Mathema, B, Martinez, J, et al. Prevalence of methicillin-resistant and methicillin-susceptible Staphylococcus aureus in the community. J Infect Dis 2000; 182:359–362.Google Scholar
14. Calfee, DP, Durbin, LJ, Germanson, TP, Toney, DM, Smith, EB, Farr, BM. Spread of methicillin-resistant Staphylococcus aureus (MRSA) among household contacts of individuals with nosocomially acquired MRSA. Infect Control Hosp Epidemiol 2003; 24:422–426.Google Scholar
15. Lesens, O, Hansmann, Y, Brannigan, E, et al. Healthcare-associated Staphylococcus aureus bacteremia and the risk for methicillin resistance: is the Centers for Disease Control and Prevention definition for community-acquired bacteremia still appropriate? Infect Control Hosp Epidemiol 2005; 26:204–209.Google Scholar
16. Friedman, ND, Kaye, KS, Stout, JE, et al. Health care–associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med 2002; 137:791–797.CrossRefGoogle ScholarPubMed
17. Eveillard, M, Martin, Y, Hidri, N, Boussougant, Y, Joly-Guillou, ML. Carriage of methicillin-resistant Staphylococcus aureus among hospital employees: prevalence, duration, and transmission to households. Infect Control Hosp Epidemiol 2004; 25:114–120.Google Scholar
18. Wagenvoort, JH, De Brauwer, EI, Sijstermans, ML, Toenbreker, HM. Risk of re-introduction of methicillin-resistant Staphylococcus aureus into the hospital by intrafamilial spread from and to healthcare workers. J Hosp Infect 2005; 59:67–68.Google Scholar
19. Comité de l'Antibiogramme de la Société Française de Microbiologie. Zone sizes and IMC break-points and non-fastidious organisms. Clin Microbiol Infect 1996; 2(Suppl 1):S1–S49.Google Scholar
20. Goering, RV, Winters, MA. Rapid method for epidemiological evaluation of gram-positive cocci by field inversion gel electrophoresis. J Clin Microbiol 1992; 30:577–580.Google Scholar
21. Enright, MC, Day, NP, Davies, CE, Peacock, SJ, Spratt, BG. Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus . J Clin Microbiol 2000; 38:1008–1015.CrossRefGoogle ScholarPubMed
22. Jarraud, S, Mougel, C, Thioulouse, J, et al. Relationships between Staphylococcus aureus genetic background, virulence factors, agr groups (alleles), and human disease. Infect Immun 2002; 70:631–641.Google Scholar
23. Oliveira, DC, de Lencastre, H. Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus . Antimicrob Agents Chemother 2002; 46:2155–2161.Google Scholar
24. Lemeshow, S, Hosmer, DW Jr. A review of goodness of fit statistics for use in the development of logistic regression models. Am J Epidemiol 1982; 115:92–106.CrossRefGoogle ScholarPubMed
25. Tambyah, PA, Habib, AG, Ng, TM, Goh, H, Kumarasinghe, G. Community-acquired methicillin-resistant Staphylococcus aureus infection in Singapore is usually “healthcare associated”. Infect Control Hosp Epidemiol 2003; 24:436–438.CrossRefGoogle ScholarPubMed
26. Pittet, D, Dharan, S, Touveneau, S, Sauvan, V, Perneger, TV. Bacterial contamination of the hands of hospital staff during routine patient care. Arch Intern Med 1999; 159:821–826.Google Scholar
27. MacKinnon, MM, Allen, KD. Long-term MRSA carriage in hospital patients. J Hosp Infect 2000; 46:216–221.Google Scholar
28. Stefani, S, Varaldo, PE. Epidemiology of methicillin-resistant staphylococci in Europe. Clin Microbiol Infect 2003; 9:1179–1186.Google Scholar
29. Chambers, HF. The changing epidemiology of Staphylococcus aureus? Emerg Infect Dis 2001; 7:178–182.CrossRefGoogle ScholarPubMed