Molecular characterization of methicillin-resistant Staphylococcus aureus disseminated in a home care system.

Abstract:

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.

authors

Rozenbaum R,Silva-Carvalho MC,Souza RR,Melo MC,Gobbi CN,Coelho LR,Ferreira RL,Ferreira-Carvalho BT,Schuenck AL,Neves FM,Silva LR,Figueiredo AM

doi

10.1086/507921

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

1041-50

issue

10

eissn

0899-823X

issn

1559-6834

pii

S0195941700070764

journal_volume

27

pub_type

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