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Frequent Acquisition of Multiple Strains of Methicillin-Resistant Staphylococcus aureus by Healthcare Workers in an Endemic Hospital Environment

Published online by Cambridge University Press:  21 June 2016

Steven M. Opal ,
Kenneth H. Mayer ,
Marjorie J. Stenberg ,
Julia E. Blazek ,
Dennis J. Mikolich ,
David L. Dickensheets ,
Lisa W. Lyhte ,
Ronald R. Trudel  and
James M. Musser
Steven M. Opal*
Affiliation:
Infectious Disease Service, Memorial Hospital and Brown University Program in Medicine, Providence, Rhode Island
Kenneth H. Mayer
Affiliation:
Infectious Disease Service, Memorial Hospital and Brown University Program in Medicine, Providence, Rhode Island
Marjorie J. Stenberg
Affiliation:
Infection Control and Laboratory Service, VA Medical Center, Providence, Rhode Island
Julia E. Blazek
Affiliation:
Infection Control and Laboratory Service, VA Medical Center, Providence, Rhode Island
Dennis J. Mikolich
Affiliation:
Infection Control and Laboratory Service, VA Medical Center, Providence, Rhode Island
David L. Dickensheets
Affiliation:
Infection Control and Laboratory Service, VA Medical Center, Providence, Rhode Island
Lisa W. Lyhte
Affiliation:
Infectious Disease Service, Memorial Hospital and Brown University Program in Medicine, Providence, Rhode Island
Ronald R. Trudel
Affiliation:
Infectious Disease Service, Memorial Hospital and Brown University Program in Medicine, Providence, Rhode Island
James M. Musser
Affiliation:
Department of Biology, Mueller Laboratory, Pennsylvania State University, University Park, Pennsylvania
*
Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860
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Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) has been an endemic nosocomial pathogen at the VA medical center (VAMC) in Providence, Rhode Island since 1981. From 1985 to 1987, more than 30% of all unique S aureus isolates were methicillin resistant. To evaluate the frequency of acquisition of MRSA isolates by healthcare workers, we compared the antimicrobial susceptibility patterns, multilocus enzyme genotypes and plasmid profiles of isolates recovered from nasal and hand cultures from VAMC nurses and house staff on rotation at the VAMC with those of clinical isolates from patients at the VAMC and four other affiliated hospitals. Fifty-six percent of ward nurses cultured (n = 112) were colonized with S aureus, of which 65% was methicillin resistant. Six isolates of MRSA were identified on the initial culturing of house staff (n=65); 16 MRSA isolates were recovered at the end of a four-week rotation (p<.02). Phenotypic and genotypic analyses demonstrated that numerous distinct MRSA strains were recovered in the study period. The incidence of MRSA among clinical isolates at the VAMC and affiliated institutions was remarkably constant throughout the three-year study period. Moreover, despite regularly sharing resident physicians, interns and medical students, MRSA isolates were uncommonly recovered at the other university-affiliated hospitals. Our study failed to reveal evidence of significant interhospital transmission of MRSA isolates by healthcare workers. While healthcare workers may contribute to the dissemination of MRSA within institutions, they appear to be less important in spreading MRSA between institutions (Infect Control Hosp Epidemiol. 1990;11:479-485.).

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 11 , Issue 9 , September 1990 , pp. 479 - 485
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

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