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Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Disseminated in a Home Care System

Published online by Cambridge University Press:  21 June 2016

R. Rozenbaum
Affiliation:
Hospital Samaritano, Rio de Janeiro, Rio de Janeiro, Brazil
M. C. Silva-Carvalho
Affiliation:
Instituto de Microbiologia Prof. Paulo de Gòes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
R. R. Souza
Affiliation:
Instituto de Microbiologia Prof. Paulo de Gòes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
M. C. N. Melo
Affiliation:
Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
C. N. Gobbi
Affiliation:
Instituto de Microbiologia Prof. Paulo de Gòes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
L. R. Coelho
Affiliation:
Instituto de Microbiologia Prof. Paulo de Gòes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
R. L. Ferreira
Affiliation:
Instituto de Microbiologia Prof. Paulo de Gòes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
B. T. Ferreira-Carvalho
Affiliation:
Instituto de Microbiologia Prof. Paulo de Gòes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
A. L. Schuenck
Affiliation:
Medlar Internacoes Domiciliares, Rio de Janeiro, Rio de Janeiro, Brazil
F. M. C. S. Neves
Affiliation:
Medlar Internacoes Domiciliares, Rio de Janeiro, Rio de Janeiro, Brazil
L. R. P. O. F. Silva
Affiliation:
Medlar Internacoes Domiciliares, Rio de Janeiro, Rio de Janeiro, Brazil
A. M. S. Figueiredo
Affiliation:
Instituto de Microbiologia Prof. Paulo de Gòes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
Corresponding
E-mail address:

Extract

Objective.

To study colonization with methicillin-resistant Staphylococcus aureus in a home care service during a 4-month period.

Design.

Prospective study.

Setting.

A home care service located in Rio de Janeiro, Brazil.

Participants.

Patients admitted to the home care service during this period, their household contacts, and health care workers (HCWs).

Methods.

Swab specimens from the anterior nares were collected from each patient in the 3 groups at admission. Screening was repeated every 7 days. MRSA was detected using a mecA probe, and the clonality of isolates was evaluated by molecular methods, primarily pulsed-field gel electrophoresis.

Results.

Of the 59 study patients, 9 (15.3%) had MRSA colonization detected; these cases of colonization were classified as imported. Only 1 (2.0%) of the 50 patients not colonized at admission became an MRSA carrier (this case of colonization was classified as autochthonous). Two (0.9%) of 224 household contacts and 16 (7.4%) of 217 HCWs had MRSA colonization. Cross-transmission from patient to HCW could be clearly demonstrated in 8 cases. The great majority of MRSA isolates belonged to the Brazilian epidemic clone.

Conclusions.

MRSA colonization was common in the home care service analyzed. The fact that the majority of MRSA isolates obtained were primarily of nosocomial origin (and belonged to the so-called Brazilian epidemic clone) substantiated our findings that all but 1 patient had already been colonized before admission to the home care service. Only cross-transmission from patients to healthcare workers could be verified. On the basis of these results, we believe that a control program built on admission screening of patients for detection of MRSA carriage could contribute to the overall quality of care.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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