• Title, Summary, Keyword: MRSA

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Molecular Epidemiology and Antimicrobial Resistance of Methicillin-resistant Staphylococcus aureus Isolated from Nasal Swab at Intensive Care Unit (중환자실 입원 환자의 비강 도말에서 메티실린 내성 황색포도알균의 분자역학, 항생제 내성 연구)

  • Kwak, Om Sub;Kwon, Mee Hye;Jeong, Ji Hyun;Kang, Mi-il;Cheun, Ji Young;Lee, Go Eun;Kim, Young Keun;Choi, Eu Gene;Na, Moon Jun;Kwon, Hee Uk;Son, Ji Woong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.91-98
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    • 2008
  • Background: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common organism associated with nosocomial infections. MRSA infections are becoming increasing important because they have emerged no only as healthcare-associated (HA) infections but also as community-associated (CA) ones. This study examined the moleculo-epidemiology of MRSA, which was isolated from nasal swabs in the intensive care unit (ICU) at Konyang University Hospital. MRSA are classified into HA-MRSA and CA-MRSA. Methods: From June to September 2006, 353 patients who were admitted to the ICU in Konyang University Hospital were enrolled in this study. Single nasal swabs were obtained for culture in the ICU on the 1st day. Pulsed-field gel electrophoresis and the antimicrobial resistant patterns were analyzed between HA- and CA-MRSA. An antimicrobial sensitivity test was also performed. Results: Forty two strains of MRSA were isolated from 353 patients (11.9%). Among the 42 isolates, HA-MRSA and CA-MRSA were found in 33 (78.6%), and 9 (21.4%), respectively. Eleven different PFGE types (type A to K) were identified. Types A (n=9) and B (n=7) were the most common for HA-MRSA, and types A (n=2) and B (n=2) were identified in CA-MRSA. The proportion of types A and B in CA-MRSA (44.4%) was similar to that in HA-MRSA (48.5%). The rates of resistance rates to erythromycin and ciprofloxacin were higher in HA-MRSA than in CA-MRSA. Conclusion: The rate of isolation of MRSA in an ICU setting was 11.9%. HA-MRSA was isolated more frequently than CA-MRSA. The rate of resistance of HA-MRSA to erythromycin and ciprofloxacin was higher than that of CA-MRSA. Despite the small number of subjects, the main isolates (type A and B) of CA-MRSA were similar to those of HA-MRSA.

Carriage Rates of Methicillin-resistant Staphylococcus aureus in Neonates with Neonatal Jaundice (신생아황달 환아에서의 메티실린내성 황색포도알균 보균율에 관한 연구)

  • Na, Dong Cheon;Seo, Jae Min;Lee, Jung Hyun;Lee, Won Uk;Kim, Eun Ryoung
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.143-153
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    • 2011
  • Purpose : It is known that carriage rates of Staphylococcus aureus (S. aureus) are highest in newborns and that the asymptomatic carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with invasive MRSA infection with the colonizing strain. This study was carried out to investigate the carriage rates of MRSA in neonates with neonatal jaundice. Methods : We reviewed the medical records of 545 neonates admitted with neonatal jaundice to neonatal intensive care units between January 2006 and December 2010. Nasal and inguinal swab specimens had been taken from them and cultured for the isolation of S. aureus. Antimicrobial susceptibility tests had been done for such isolates to determine methicillinresistance. Results : Out of 545 neonates, 318 (58.3%) were colonized with S. aureus and 214 (39.3%) were colonized with MRSA. Results of the antibiogram analysis showed that 65.7% of MRSA isolates were likely to be community-associated (CA) MRSA. Conclusion : Based on the MRSA carriage rate of 39.3%, a surveillance program for MRSA colonization is considered necessary in neonates transferred from other clinics or hospitals. Out of MRSA isolates, 65.7% were likely to be CA-MRSA. This suggests that CA-MRSA strains were already present in obstetric clinic environments where the neonates were born. It is thought that MRSA surveillance programs in these environments are also necessary.

Colonization Rate of Methicillin-resistant Staphylococcus aureus in Neonates: A Single Center Experience (단일병원 신생아 환자의 메티실린내성 황색포도알균 보균율)

  • Choi, Soo Young;Han, Sang Woo;Yoon, Hye Sun;Ki, Moran
    • Pediatric Infection and Vaccine
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    • v.19 no.3
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    • pp.111-120
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    • 2012
  • Purpose: The aim of this study is to investigate the colonization rate of Methicillin-resistant Staphylococcus aureus (MRSA) in neonates by different clinical characteristics, to presume the origin of MRSA acquisition, and to identify the risk factors associated with MRSA colonization. Methods: We retrospectively reviewed the medical records of 1,733 neonates admitted to Seoul Eulji hospital Neonatal Intensive Care Unit between January 2008 and December 2011. Nasal, inguinal and rectal swab specimens were obtained upon admission and each week until discharge. We classified the route of MRSA acquisition as; hospital associated (HA-MRSA) and community associated (CA-MRSA) according to the case definition. Results: Among 1,733 neonates, 415 (23.9%) were colonized with MRSA. Gestational age, birth weight, delivery type, maternal antibiotics usage before delivery, birth place and care place before admission were influencing factors in colonization of MRSA. The colonization rate was significantly high in neonates without maternal prophylactic antibiotics use before delivery than in the other group (relative risk 2.77, 95% CI 1.88-4.07; P<0.01), and outborns showed higher MRSA colonization rate compared to inborns (relative risk 2.28, 95% CI 1.17-4.42; P=0.015). Conclusion: We identified the neonatal MRSA colonization rate to be 23.9%. We estimated HA-MRSA colonization rate to be 10% (51/511) and CA-MRSA colonization rate to be 36% (309/858). We ascertained that risk factors in MRSA colonization in neonates were prophylactic use of antibiotics in mothers and the birth place.

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The Effect of Handwashing Improving Program and MRSA Carrier Screening Program on the MRSA Infection Rates in an Intensive Care Unit (손씻기 향상프로그램과 MRSA 보균자 색출프로그램이 MRSA감염 발생률에 미치는 영향)

  • 김영혜;전성숙;정인숙;장철훈;김정화;허정애
    • Journal of Korean Academy of Nursing
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    • v.33 no.6
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    • pp.686-692
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    • 2003
  • Purpose: To assess the effect of handwashing improving program and MRSA carrier detection program on MRSA(methicillin resistant Staphylococcus aureus) infection rate in a intensive care unit. Method: The intervention was Nosocomial Infection(NI) control program consisted of hand washing improving program and identification and treatment of MRSA carrier. Data on the NI and MRSA infections were collected by an infection control nurse based on the definition of CDC. MRSA infection rates were calculated by the number of MRSA infection per 100 admissions or 1,000 patients-days. The difference of MRSA infection rates between pre and post intervention was tested by Chi-square at =.05. Result: MRSA infection rates 3.0% or 3.2 per 1,000 patient-days at the pre, 4.6% or 3.7 per 1,000 patient-days at the post, and the differences were not statistically significant (p=.411, p=.769 respectively). Conclusion: The handwashing improving program and MRSA carrier detection program was not effective in reducing the Nosocomial Infection(NI) or MRSA infection rates. It is recommended further studies with a longer intervention and follow-up period.

Antimicrobial Susceptibility and Clonal Relatedness between Community- and Hospital-Acquired Methicillin-Resistant Staphylococcus aureus from Blood Cultures

  • Jung Sook-In;Shin Dong-Hyeon;Park Kyeong-Hwa;Shin Jong-Hee
    • Journal of Microbiology
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    • v.44 no.3
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    • pp.336-343
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    • 2006
  • We compared the antimicrobial resistance and clonal relationships among the community-acquired (CA) and hospital-acquired (HA) methicillin-resistant Staphylococcus aureus (MRSA) strains that were isolated from blood cultures in a university hospital over a 4-year period. A total of 131 MRSA isolates, including 28 CA-MRSA and 103 HA-MRSA strains, were identified; antimicrobial susceptibility testing indicated that the CA-MRSA isolates were more susceptible to erythromycin (21 % vs 6% ; P=0.02), clindamycin (46% vs 12%; P<0.01), ciprofloxacin (43% vs 11%; P<0.01), and gentamicin (43% vs 6%; P<0.01) than were the HA-MRSA isolates. Pulsed-field gel electrophoresis (PFGE) typing and antimicrobial resistance profiles separated the 20 CA-MRSA isolates into 14 and 10 different patterns, respectively, and the 53 HA-MRSA isolates were separated into 24 and 7 different patterns, respectively. Twenty-one (40%) of the 53 HA-MRSA isolates belonged to two predominant PFGE types, and most of them showed multi-drug resistant patterns. Four (20%) of the 20 CA-MRSA and 10 (19%) of the 53 HA-MRSA isolates fell into two common PFGE patterns, and each of them showed the same multi-drug resistant pattern. This study suggests that, although the CA-MRSA blood isolates showed diverse PFGE and antimicrobial resistance patterns, some of these isolates may have originated from the HA-MRSA strains.

Knowledge and Performance Level of Infection Control with MRSA of Medium and Small Hospital Nurses (중소병원 간호사의 메치실린 내성 황색포도알균 감염관리의 지식과 수행정도)

  • Kim, Tae-Kyung;Min, Hye-Sook;Jung, Ha-Yun
    • The Korean Journal of Health Service Management
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    • v.6 no.3
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    • pp.157-169
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    • 2012
  • This survey was undertaken to identify knowledge and performance level of MRSA infection control among medium and small hospital nurses. The subjects of the study were 261 medium and small hospital nurses. The collected data were analyzed by using SPSS WIN 18.0. The total mean values of the knowledge and performance on the MRSA infection control were $9.51{\pm}1.67$ and $2.26{\pm}.47$ respectively. the Knowledge about the general characteristics according to work department, MRSA infection control department presence, MRSA infection control guidelines presence, MRSA infection control education experience, MRSA infection control education method according to the statistically significant differences were observed. The performance about general characteristics according to age, work experience, work department, MRSA infection control department presence, MRSA infection control guidelines presence, MRSA infection control education experience and MRSA infection control education methods according to the statistically significant differences were observed. It is having sufficient various facilities, to enhance nurses knowledge about management of MRSA infection. If the continuous education of professional infection control is offered, it contributes to protect MRSA infection in the medium and small hospitals.

Clinical Manifestation and Treatment of Methicillin-resistant Staphylococcus aureus Infections in Children (소아 메티실린내성 황색포도알균 감염증의 임상양상과 치료)

  • Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.16 no.1
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    • pp.1-5
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    • 2009
  • Methicillin-resistant Staphylococcus aureus (MRSA), a leading cause of nosocomial infections, has been increasingly recognized in communities of the United States. This article will review the clinical spectrum and treatment of MRSA infections in children in the context of recent epidemiological changes of MRSA infections. In general, community-associated (CA) MRSA most frequently causes skin and soft tissue infections and has an increased association with invasive infections, particularly pneumonia and musculoskeletal infections. Hospital-associated (HA) MRSA strains tend to be associated with bloodstream infections, pneumonia, and surgical site infections. Different from the United States, CA-MRSA infections are not common in Korea (only 5.9%); however, there are some CA-MRSA clones that are different from HA-MRSA clones in Korea and from CA-MRSA clones in other countries. The treatment of MRSA infections should be guided by antimicrobial susceptibility testing, the site of infection, and the infection severity. Vancomycin is the treatment of choice for invasive MRSA infections. Other agents such as trimethoprim-sulfamethoxazole, clindamycin, linezolid, quinupristin-dalfopristin, and daptomycin have been used for some conditions.

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Comparison Between Antimicrobial Susceptibility Test and mecA PCR Method for Reading of Methicillin-Resistant Staphylococcus aureus (메티실린 내성 황색포도알균 판독에 있어 항균제 감수성 검사와 mecA PCR법의 비교)

  • Kim, Su-Jung
    • Korean Journal of Microbiology
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    • v.47 no.4
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    • pp.381-385
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    • 2011
  • Methicillin-resistant Staphylococcus aureus (MRSA) is one of major pathogen causing hospital infection and several diseases such as purulent infection, bacteremia. The isolation ratio of MRSA is gradually increased up to 80% in the hospital, which makes a limitation for treatment of antibiotics because the isolated MRSA show resistance to methicillin as well as other antibiotics. This study proposes that mecA detecting methods which are not commonly used because of cost in the hospital is a more accurate method than Susceptibility Testing to detect a MRSA. We compared Staphylococcus aureus ATCC 29213 as a negative control and 20 MRSA strains isolated from patients by these two methods. We amplified mecA gene by polymerase chain reaction (PCR) and confirmed the PCR products by sequencing. All of the MRSA showed oxacillin and cefoxitin resistance whereas 85% (16/19) of the strains had mecA wildtype. These results suggest that some of the MRSA are mecA mutants therefore mecA genotyping reinforces the MRSA detection by antibiotic susceptibility test.

The Epidemiological Survey of Nasal Colonization of Methicillin Resistant Staphylococcus aureus in Patients and Doctors

  • Seong Hee Kyung;Bae Young Soon;Kim Yong Ho
    • Biomedical Science Letters
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    • v.10 no.3
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    • pp.309-315
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    • 2004
  • Methicillin resistant Staphylococcus aureus (MRSA) is one of the most common nosocomial pathogens. Many hospitals are facing the problems which they have to use expensive antibiotics and suffer from long term hospital study of patients due to MRSA. This study is to survey MRSA nasal colonization of patients and doctors, and to investigate the mode of transmission of MRSA by pulsed field gel electrophoresis (PFGE) and then use these data to prevent further spread of cross infection and reduce nosocomial infection. Subjects of this study were 201 patients with MRSA infection at an university hospital in Busan from Sept. 1997 to Aug. 1998. Bacterial genotypes of MRSA strains isolated from nares and wound of patients (14 cases) and nares of doctors (8 cases) were analyzed by PFGE. Nasal cultures of 20 I patients for detecting nasal colonization of MRSA were performed and incidence rate of nasal colonization was 40% (80/201). Among 201 patients MRSA were acquired from hospital in 140 (70%) patients and were acquired from community 61 (30%) patients. Among 14 pairs of MRSA from colonized or infected sites and anterior nares, DNA patterns of 10 pairs (71.4%) were equal. 86% (12/14) MRSA strains isolated from patients and 12.5% (1/8) MRSA strains isolated from doctors show same pattern. DNA patterns were changed in some doctors after nasal oint. Treatment. It could be inferred that the most sources of MRSA in hospital are the endemically existing MRSA. Therefore, we believe that it would be necessary to control MRSA nasal colonization of the patients and the related medical teams to reduce the medical cost and to improve the efficacy of medical cares.

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Anti-MRSA Properties of Prodigiosin from Serratia sp. PDGS 120915 (Serratia sp. PDGS 120915가 생산하는 prodigiosin의 항 MRSA 특성에 관한 연구)

  • Ji, Keunho;Jeong, Tae Hyug;Kim, Young Tae
    • Journal of Life Science
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    • v.25 no.1
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    • pp.29-36
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    • 2015
  • Prodigiosin, a member of natural red pigment family, is produced by Serratia marcescens, and characterized by a common pyrrolylpyrromethane skeleton. This pigment has been reported with the effects of anticancer, immunosuppressant, antifungal, and algicidal activities. Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of hospital infections. In this study, anti-MRSA properties of prodigiosin isolated from Serratia sp. PDGS 120915 were investigated. We identified and purified prodigiosin using high performance liquid chromatography (HPLC) and evaluated anti-MRSA activity. Purified prodigiosin inhibited the growth of MRSA. The minimum inhibitory concentrations (MICs) of prodigiosin were determined to $32{\mu}g/ml$ against the MRSA strains. Fractional inhibitory concentration (FIC) indices of ampicillin and penicillin were indicated synergistic effects of prodigiosin on MRSA.