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Prevalence and Characteristics of Staphylococcus aureus Colonization among Healthcare Professionals in an Urban Teaching Hospital

Published online by Cambridge University Press:  02 January 2015

Marie-Carmelle Elie-Turenne ,
Helen Fernandes ,
José R. Mediavilla ,
Marnie Rosenthal ,
Barun Mathema ,
Ashima Singh ,
Tiffany R. Cohen ,
Kimmerle A. Pawar ,
Hosseinali Shahidi  and
Barry N. Kreiswirth
...Show all authors
Marie-Carmelle Elie-Turenne*
Affiliation:
Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey, Newark, New Jersey Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Helen Fernandes
Affiliation:
New Jersey Medical School, the Department of Pathology, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
José R. Mediavilla
Affiliation:
Public Health Research Institute, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Marnie Rosenthal
Affiliation:
Public Health Research Institute, University of Medicine and Dentistry of New Jersey, Newark, New Jersey Department of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts
Barun Mathema
Affiliation:
Public Health Research Institute, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Ashima Singh
Affiliation:
Department of Health Informatics, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Tiffany R. Cohen
Affiliation:
Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey, Newark, New Jersey Department of Emergency Medicine, Beth Israel Medical Center, New York, New York
Kimmerle A. Pawar
Affiliation:
Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey, Newark, New Jersey Department of Emergency Medicine, New York University, New York, New York
Hosseinali Shahidi
Affiliation:
Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Barry N. Kreiswirth
Affiliation:
Public Health Research Institute, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Edwin A. Deitch
Affiliation:
Department of Surgery, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
*
University of Medicine and Dentistry of New Jersey-New Jersey Medical School, UH M219, 150 Bergen Street, Newark, NJ 07103, ([email protected])
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Extract

Objective.

To determine the prevalence of asymptomatic carriage of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) among healthcare professionals (HCPs) who experience varying degrees of exposure to ambulatory patients and to genetically characterize isolates.

Methods.

This single-center, cross-sectional study enrolled 256 staff from the intensive care units, emergency department, and prehospital services of an urban tertiary care university hospital in 2008. Occupational histories and nasal samples for S. aureus cultures were obtained. S. aureus isolates were genetically characterized with the use of spa typing and screened for mecA. MRSA isolates underwent further characterization.

Results.

S. aureus was isolated from 112 of 256 (43.8%) HCPs, including 30 of 52 (57.7%) paramedics, 51 of 124 (41.1%) nurses, 11 of 28 (39.3%) clerical workers, and 20 of 52 (38.5%) physicians. MRSA was isolated from 17 (6.6%) HCPs, including 1 (1.9%) paramedic, 13 (10.5%) nurses, 1 (3.6%) clerical worker, and 2 (3.8%) physicians. Among S. aureus isolates, 15.2% were MRSA. MRSA prevalence was 9.6% (12/125) in emergency department workers, 5.1% (4/79) in intensive care unit workers, and 1.9% (1/52) in emergency medical services workers. Compared with paramedics, who had the lowest prevalence of methicillin resistance among S. aureus isolates (1 of 30 [3.3%] isolates), nurses, who had the highest prevalence (13 of 51 [25.4%] isolates), had an odds ratio of 9.92 (95% confidence interval, 1.32-435.86; P = .02) for methicillin resistance. Analysis of 15 MRSA isolates revealed 7 USA100 strains, 6 USA300 strains, 1 USA800 strain, and 1 EMRSA-15 strain. All USA300 strains were isolated from emergency department personnel.

Conclusions.

The observed prevalence of S. aureus and MRSA colonization among HCPs exceeds previously reported prevalences in the general population. The proportion of community-associated MRSA among all MRSA in this colonized HCP cohort reflects the distribution of the USA300 community-associated strain observed increasingly among US hospitalized patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 6 , June 2010 , pp. 574 - 580
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

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