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Methicillin-Resistant Staphylococcus aureus in Tertiary Care Institutions of the Canadian Prairies 1990-1992

Published online by Cambridge University Press:  02 January 2015

J. Embil
Affiliation:
Departments of Internal Medicine, University of Manitoba
K. Ramotar
Affiliation:
Calgary General Hospital, Calgary, Alberta University of Calgary, Calgary, Alberta
L. Romance
Affiliation:
Health Sciences Centre
M. Alfa
Affiliation:
St. Boniface General Hospital, University of Manitoba Medical Microbiology, University of Manitoba
J. Conly
Affiliation:
Royal University Hospital, Saskatoon, Saskatchewan University of Saskatchewan, Saskatoon, Saskatchewan
S. Cronk
Affiliation:
Royal University Hospital, Saskatoon, Saskatchewan
G. Taylor
Affiliation:
University Hospital, Edmonton, Alberta University of Alberta, Edmonton, Alberta
B. Sutherland
Affiliation:
University Hospital, Edmonton, Alberta
T. Louie
Affiliation:
Calgary General Hospital, Calgary, Alberta University of Calgary, Calgary, Alberta
E. Henderson
Affiliation:
Calgary General Hospital, Calgary, Alberta
L.E. Nicolle
Affiliation:
Health Sciences Centre Departments of Internal Medicine, University of Manitoba Medical Microbiology, University of Manitoba

Abstract

Objective:

To review experience with methicillin-resistant Staphylococcus aureus (MRSA) in tertiary acute-care teaching hospitals on the Canadian prairies.

Design:

Retrospective review for a 36-month period, 1990 through 1992.

Setting:

Five tertiary acute-care teaching hospitals in three Canadian prairie provinces.

Methods:

MRSA isolates and susceptibility were identified through the clinical microbiology laboratory at each institution. For each patient, data collected included duration of institutional residence prior to isolation, patient ethnic background, age, sex, and antimicrobial susceptibility. Epidemiologic typing of strains used restriction fragment length polymorphism analysis by pulsed-field gel electrophoresis.

Results:

Two hundred fifty-nine MRSA isolates were identified in 135 patients during the 36 months, with substantial institutional variation in number of isolates. No consistent increase in yearly numbers of isolates was apparent. Patients usually had MRSA identified at admission (62%); only one of five centers had the majority of isolates acquired nosocomially. Patients with MRSA present at admission were more frequently of aboriginal (First Nations) ethnicity (62% compared with 14% of nosocomial; P<0.001). Pulsed-field gel electrophoresis of 167 isolates from 135 patients revealed 46 different strains with little interprovincial or inter-institutional identity of strains.

Conclusions:

MRSA isolated in patients in tertiary care institutions in these three Canadian provinces usually is acquired prior to admission. A disproportionate number of isolates are identified in aboriginal Canadians. Epidemiologic typing was consistent with a polyclonal origin of MRSA in this geographic area.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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