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The Evolving Epidemiology of Methicillin-Resistant Staphylococcus aureus at a University Hospital

Published online by Cambridge University Press:  02 January 2015

Marcelle C. Layton ,
Walter J. Hierholzer Jr  and
Jan Evans Patterson
Marcelle C. Layton
Affiliation:
Department of Medicine, Section of Infectious Diseases, New Haven, Connecticut
Walter J. Hierholzer Jr
Affiliation:
Department of Medicine, Section of Infectious Diseases, New Haven, Connecticut Department of Epidemiology and Public Health, New Haven, Connecticut
Jan Evans Patterson*
Affiliation:
Department of Medicine, Section of Infectious Diseases, New Haven, Connecticut Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut
*
Department of Medicine, Division of Infectious Diseases, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78284-7881
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Abstract

Objective:

To describe the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) at a university hospital during a 14-month period.

Design:

Prospective laboratory-based surveillance for MRSA with descriptive epidemiology based on medical chart review and characterization of strains by DNA typing, using pulsed-field gel electrophoresis (PFGE).

Setting:

An 850-bed tertiary care university hospital.

Patients:

Patients with clinical isolates of MRSA.

Main Outcome Measure:

Determination whether MRSA isolates were community- or hospital-related.

Results:

Among 87 patients with MRSA, 36 (41%) had community-acquired infections. Community acquisition was associated with recent hospitalization, previous antibiotic therapy, nursing home residence, and intravenous drug use. Greater than 3 months had elapsed from the time of discharge for 13 (62%) of the 21 patients with community-acquired isolates hospitalized within the last year. Eight patients (22%) with community-acquired MRSA had no discernible risk factors. PFGE allowed differentiation of 35 distinct whole-cell DNA patterns; heterogeneity was seen among both nosocomial and community-acquired isolates, with few instances of cross-transmission.

Conclusions:

Our data suggest an increase in community acquisition of MRSA. PFGE demonstrated heterogeneity of MRSA isolates from both the community and the hospital setting.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 16 , Issue 1 , January 1995 , pp. 12 - 17
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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