Control of Methicillin-Resistant Staphylococcus aureus in a Hospital and an Intensive Care Unit
Infection Control and Hospital EpidemiologyPublished 1 July 1995
Alan I. Hartstein, Mark A. Denny, Virginia H. Morthland, Ann M. LeMonte, Michael A. Pfaller
Citations102
SJR quartileQ1
SJR score1.05
SNIP0.98
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
MRSA in hospitals and outbreaks of MRSA in ICUs can be controlled by surveillance and minimal barrier interventions, including a surgical intensive care unit (SICU) outbreak in 1992.
Abstract
MRSA in hospitals and outbreaks of MRSA in ICUs can be controlled by surveillance and minimal barrier interventions. REAP or PFGE typing of MRSA can be used to support or refute the presence of cross-transmission. Typing also may be helpful when planning and assessing the effectiveness of interventions directed at endemic, as well as outbreak, MRSA control.
Keywords
MedicineBiochemistry, Genetics and Molecular Biology
Infection Control and Hospital EpidemiologyGuideline for Isolation Precautions in Hospitals
1,002 Citations1996Julia S. Garner
Describe los razonamientos y responsabilidades para las precauciones del aislamiento, las tecnicas, recomendaciones and modificaciones.
New England Journal of MedicineMethicillin-Resistant Staphylococcus aureus
954 Citations1989W. Brumfitt, J. M. T. Hamilton‐Miller
In the early 1940s the introduction of benzylpenicillin (Penicillin G) temporarily solved the problem of staphylococcal infections, but the continued use of this agent caused the selection of resistant strains, which produced penicillinase (β-lactamase).
Annals of Internal MedicinePrevention and Control of Nosocomial Infections.
724 Citations1987
The role of the hospital epidemiologist in protecting the environment laboratory-acquired infections infectious biohazards associated with laboratory animal research nosocomial infections related to patient care support and protection from blood and blood products.
Annals of Internal MedicineEpidemiology of Nosocomial Infections Caused by Methicillin-Resistant <i>Staphylococcus aureus</i>
674 Citations1982Robert L. Thompson, Ignacio Cabezudo +1 more
A program designed to control a widespread outbreak in a university hospital used three surveillance methods to identify the major institutional reservoir of colonized and infected inpatients and found transient carriage on the hands of hospital personnel appears to be the most important mechanism of serial patient-to-patient transmission.
The American Journal of MedicineMethicillin-resistant Staphylococcus aureus: A consensus review of the microbiology, pathogenesis, and epidemiology with implications for prevention and management
655 Citations1993Maury E. Mulligan, Katherine A. Murray-Leisure +6 more
Indications for antibiotic therapy for eradication of colonization and treatment of infection are reviewed, and recommendations for handling an outbreak, surveillance, and culturing of patients are presented based on the known epidemiology.
Infection Control and Hospital EpidemiologyMethicillin-Resistant <i>Staphylococcus aureus</i> in U.S. Hospitals, 1975–1991
599 Citations1992Adelisa L. Panlilio, David H. Culver +6 more
This study suggests that hospitals of all sizes are facing the problem of MRSA, the problem appears to be increasing regardless of hospital size, and control measures advocated for MRSA appear to require re-evaluation.
Journal of Clinical MicrobiologyComparison of traditional and molecular methods of typing isolates of Staphylococcus aureus
516 Citations1994Fred C. Tenover, Robert D. Arbeit +8 more
Phage typing, plasmid DNA restriction analysis, and antibiogram analysis, the techniques most readily available to clinical laboratories, identified 23 to 26 of 29 outbreak-related isolates and assigned 0 to 6 unrelated isolates to outbreak strain types.
Clinical Infectious DiseasesMolecular Epidemiology: Application of Contemporary Techniques to the Typing of Microorganisms
426 Citations1993J. N. Maslow, Maury E. Mulligan +1 more
This research presents a novel and scalable approach to promotor-free vaccination of canine coronavirus that aims to provide real-time information about the immune defences of the immune system and how these defences are damaged during infection.
Annals of Internal MedicineMethicillin-Resistant <i>Staphylococcus aureus:</i> Introduction and Spread Within a Hospital
409 Citations1980James E. Peacock, FREDERIC J. MARSIK +1 more
Patients acquiring methicillin-resistant S. aureus in the intensive care unit had a longer mean stay, had higher overall mortality, and received nafcillin and aminoglycosides more frequently than did cohorted control subjects.
The Journal of Infectious DiseasesAn Outbreak of Infections Caused by Strains of Staphylococcus aureus Resistant to Methicillin and Aminoglycosides. I. Clinical Studies
395 Citations1979Kay M. Crossley, Danuta Z. Loesch +4 more
Stains of Staphylococcus aureus resistant to methicillin and multiple aminoglycosides, (designated MARS) were recovered from 108 inpatients with nosocomial infections at a hospital in the midwestern United States, and recovered from the burn wounds of 64%; 32% of the patients with burns had MARS bacteremia.
The American Journal of MedicineEpidemiology and control of nosocomial infections in adult intensive care units
296 Citations1991Robert A. Weinstein
Improvements in the design and aseptic care of invasive devices have helped to decrease the risk of progression from colonization to infection in individual patients, and interest is growing also in use of selective decontamination to decrease ICU infection rates.
Infection Control and Hospital EpidemiologyMethicillin-Resistant <i>Staphylococcus aureus</i> in U.S. Hospitals, 1975–1991
281 Citations1992Adelisa L. Panlilio, David H. Culver +6 more
This study suggests that hospitals of all sizes are facing the problem of MRSA, the problem appears to be increasing regardless of hospital size, and control measures advocated for MRSA appear to require re-evaluation.
The American Journal of MedicineMethicillin-resistant Staphylococcus aureus: Implications for the 1990s and effective control measures
216 Citations1991Richard P. Wenzel, Mary D. Nettleman +2 more
Current available data suggest the efficacy of three measures: identification of the entire patient reservoir (cases and carriers) for purposes of isolation, strict handwashing between patients to prevent transmission, and treatment of the carrier state in health care workers and patients during periods of high infection rates with safe and effective topical agents such as mupirocin.
Annals of Internal MedicineRethinking the Role of Isolation Practices in the Prevention of Nosocomial Infections
207 Citations1987Patricia Lynch, MARGUERITE M. JACKSON +2 more
This work proposes the use of body substance isolation, a simpler alternative system that is used for all patients, not just in response to a specific diagnosis, and that emphasizes the increased use of barrier precautions, especially gloving, when contact with potentially infectious bodily secretions is anticipated.
Infection Control and Hospital EpidemiologyThe Role of Handwashing in Prevention of Endemic Intensive Care Unit Infections
206 Citations1990Bryan Simmons, Jerri K. Bryant +3 more
It is concluded that handwashing rates, when measured against arbitrary but reasonable standards, are suboptimal, difficult to change and not closely related to evidence of cross-infection.
New England Journal of MedicineReduction of Nosocomial Infection during Pediatric Intensive Care by Protective Isolation
198 Citations1989Bruce S. Klein, William H. Perloff +1 more
It is concluded that the use of disposable, high-barrier gowns and gloves for the care of selected, high -risk children who require prolonged intensive care significantly reduces the incidence of nosocomial infection, is well tolerated, and does not compromise the delivery of care.
Infection Control and Hospital EpidemiologyMethicillin-Resistant <i>Staphylococcus aureus</i> in Hospitals and Long-Term Care Facilities: Microbiology, Epidemiology, and Preventive Measures
198 Citations1992John M. Boyce
Infection Control and Hospital EpidemiologyThe Evolving Epidemiology of Methicillin-Resistant Staphylococcus aureus at a University Hospital
195 Citations1995Marcelle Layton, Walter J. Hierholzer +1 more
Among 87 patients with MRSA, 36 had community-acquired infections, and community acquisition was associated with recent hospitalization, previous antibi
Infection Control and Hospital EpidemiologyMethicillin-Resistant Staphylococcus aureus (MRSA): A Briefing for Acute Care Hospitals and Nursing Facilities
192 Citations1994John M. Boyce, Marguerite M. Jackson +9 more
There is lack of agreement on the most appropriate measures to control MRSA in healthcare facilities, and the wide variation in approaches is due, in part, to the lack of data establishing the efficacy of specific control measures.
Infection Control and Hospital EpidemiologyMolecular Epidemiology of Nosocomial Infection: Analysis of Chromosomal Restriction Fragment Patterns by Pulsed-Field Gel Electrophoresis
146 Citations1993Neil L. Barg, Richard V. Goering
Infection Control and Hospital EpidemiologyIncreasing Prevalence of Methicillin-Resistant <i>Staphylococcus aureus</i> in the United States
126 Citations1990John M. Boyce
Infection Control and Hospital EpidemiologyShould We Vigorously Try to Contain and Control Methicillin-Resistant <i>Staphylococcus aureus?</i>
116 Citations1991John M. Boyce
Journal of Clinical MicrobiologyGastrointestinal carriage of methicillin-resistant Staphylococcus aureus
105 Citations1986David Rimland, Bob S. Roberson
Rectal colonization, probably reflecting gastrointestinal carriage, may be a source of transmission of methicillin-resistant S. aureus in hospitalized patients and may be difficult to eradicate.
Journal of Clinical MicrobiologyMolecular epidemiology of nosocomial invasive aspergillosis
102 Citations1994H Girardin, J. Sarfati +4 more
Fingerprint strains of Aspergillus fumigatus isolated from patients with invasive aspergillosis and their hospital environment showed different Southern blot hybridization patterns and a temporal survey of air contaminants showed that some strains can persist in the same environment for at least 6 months.
Infection ControlProspective Microbiologic Surveillance in Control of Nosocomial Methicillin-Resistant<i>Staphylococcus aureus</i>
92 Citations1987Thomas J. Walsh, David Vlahov +5 more
The PMS program was studied over three and one half years for its contribution to infection control of MRSA, early identification of nosocomial MRSA outbreaks, use of the highest yield surveillance culture sites, and cost effectiveness.
Clinical Infectious DiseasesAssessment of Bacterial Cross-Transmission as a Cause of Infections in Patients in Intensive Care Units
90 Citations1994Ploenchan Chetchotisakd, Charles L. Phelps +1 more
Episodes of possible cross-transmission were scattered among all ICUs, usually affected only two patients, and were associated with most bacterial species, suggesting that endemic bacterial cross- transmissible bacteria are not common causes of endemic ICU-related nosocomial infections.
The American Journal of MedicineA seven-year experience with methicillin-resistant Staphylococcus aureus
89 Citations1991Stuart H. Cohen, Margaret Morita +1 more
It is concluded that the use of contact isolation with some modifications has saved time and money and has successfully controlled the spread of MRSA in the authors' university hospital.
Infection Control and Hospital EpidemiologyEpidemiologic and Clinical Utility of Typing Systems for Differentiating Among Strains of Methicillin-Resistant <i>Staphylococcus aureus</i>
81 Citations1991Maury E. Mulligan, Robert D. Arbeit
Typing systems for differentiating among strains of methicillin-resistant Staphylococcus aureus (MRSA) can be valuable tools for the epidemiologist and the clinician, but have limitations in typeability and/or discriminatory power.
American Journal of Infection ControlHigher overall nosocomial infection rate because of increased attack rate of methicillin-resistantStaphylococcus aureus
80 Citations1993Alan M. Stamm, Martha Long +1 more
The total nosocomial infection rate has increased as a result equally of the emergence of methicillin-resistant S. aureus and of the renewed activity of other gram-positive pathogens.
Infection ControlMethicillin-resistant<i>Staphylococcus aureus</i>in Veterans Administration Medical Centers
76 Citations1987Laurel C. Preheim, David Rimland +1 more
Improved regimens to eliminate MRSA carriage are needed as MRSA incidence is increasing at Veterans Administration Medical Centers across the United States.
Infection Control and Hospital EpidemiologyCost-Effective Eradication of an Outbreak of Methicillin-Resistant Staphylococcus aureus in a Community Teaching Hospital
75 Citations1988Nalini Rao, Sharon Jacobs +1 more
The incidence of nosocomial cases of MRSA fell to zero in the five months following the implementation of the strategy, and the cost of the entire eradication process was approximately half that of treating a single MRSA bacteremia.
Journal of Clinical MicrobiologyRestriction enzyme analysis of plasmid DNA and bacteriophage typing of paired Staphylococcus aureus blood culture isolates
70 Citations1989A I Hartstein, Virginia H. Morthland +4 more
Infection ControlStrict Versus Modified Isolation for Prevention of Nosocomial Transmission of Methicillin-Resistant<i>Staphylococcus aureus</i>
63 Citations1986Bruce S. Ribner, Martha N. Landry +1 more
Total new acquisitions of MRSA in the hospital have decreased over the subsequent 6-month period, and all hospitalized patients with MRSA were placed in modified isolation precautions.
The American Journal of MedicineReemergence of epidemic methicillin-resistant Staphylococcus aureus in a general hospital associated with changing Staphylococcal strains
54 Citations1991Calvin C. Linnemann, Peggy Moore +2 more
Between the two epidemics of methicillin-resistant Staphylococcus aureus infections at the University of Cincinnati Hospital, there was a major change in the MRSA recovered from infected patients, as demonstrated by three epidemiologic markers.
Infection Control and Hospital EpidemiologyShould We Vigorously Try to Contain and Control Methicillin-Resistant <i>Staphylococcus aureus?</i>
53 Citations1991John M. Boyce
Reviewing practices currently used to control transmission of methicillin-resistant Staphylococcus aureus in hospitals finds the value of some practices is well established, but measures such as routinely attempting to eradicate carriage of MRSA by colonized patients and personnel require further evaluation.
Infection Control and Hospital EpidemiologyCost-Effective Eradication of an Outbreak of Methicillin-Resistant Staphylococcus aureus in a Community Teaching Hospital
44 Citations1988Nalini Rao, Sharon Jacobs +1 more
Infection Control and Hospital EpidemiologyEffectiveness of Simple Measures to Control an Outbreak of Nosocomial Methicillin-Resistant <i>Staphylococcus aureus</i> Infections in an Intensive Care Unit
39 Citations1990Marguerite Guiguet, Claire Rekacewicz +4 more
Simple control measures including contact isolation of colonized patients and reinforcement of handwashing practices among personnel were followed by a sharp decrease in the rate of infection and colonization, stressing the effectiveness of simple measures to control outbreaks of MRSA nosocomial infections even in immunocompromised cancer patients.
Diagnostic Microbiology and Infectious DiseaseThe clinical microbiology laboratory as an aid in infection control the application of molecular techniques in epidemiologic studies of methicillin-resistant Staphylococcus aureus
37 Citations1991Michael A. Pfaller, Douglas S. Wakefield +4 more
Molecular typing methods, such as REAP, when used appropriately in conjunction with careful epidemiologic investigation provide an effective approach to the investigation and control of the spread of MRSA within the hospital.
JAMARecurrent Epidemics Caused by a Single Strain of Erythromycin-Resistant Staphylococcus aureus
36 Citations1993Nancy A. Back
Traditional epidemic investigations may lead to false conclusions that can be recognized with molecular epidemiologic techniques, and for these techniques to be useful in the control of outbreaks, plasmid analysis and/or genotyping must be readily available.
Infection Control and Hospital EpidemiologyMethicillin-Resistant <i>Staphylococcus aureus:</i> A Questionnaire Survey of 75 Long-Term Care Facilities in Western New York
35 Citations1992Joseph M. Mylotte, Jurgis Karuza +1 more
To determine the frequency of recognition of methicillin-resistant Staphylococcus aureus as an infection control problem and its prevalence among long-term care facilities, and to evaluate whether certain longterm care facility characteristics are related to the recognition or prevalence of MRSA in this setting.
Current topics in medical mycologyThe Use of Molecular Techniques for Epidemiologic Typing of Candida Species
32 Citations1992Michael A. Pfaller
Current data suggest that the molecular typing methods of restriction endonuclease digestion of genomic DNA with ethidium bromide staining (DEtBr typing) and electrophoretic karyotyping using pulsed-field electrophoresis offer rapid, simple, and sensitive means of discriminating strains of Candida species.
Infection Control and Hospital EpidemiologyMethicillin-Resistant <i>Staphylococcus aureus</i> in a Nursing Home and Affiliated Hospital: A Four Year Prespective
29 Citations1993Larry J. Strausbaugh, Cleone Jacobson +1 more
The MRSA outbreak in the NHCU was associated with only a modest increase in the MRSA caseload at the affiliated hospital.
Diagnostic Microbiology and Infectious DiseaseMedical technologists using molecular epidemiology as part of the infection control team
22 Citations1993Lance R. Peterson, Robert A. Petzel +3 more
Two medical technologists were appointed as permanent members of a new epidemiology section in the diagnostic microbiology laboratory of a large Veterans Administration Medical Center in the fall of 1989 and have evaluated outbreaks due to Clostridium difficile, methicillin-susceptible Staphylococcus aureus, and Serratia marcescens, and begun work on a methamphetamine-resistant MRSA-typing scheme.
Infection Control and Hospital EpidemiologyRestriction Endonuclease Analysis of Plasmid DNA From Methicillin-Resistant <i>Staphylococcus aureus</i> : Clinical Application Over a Three-Year Period
22 Citations1993Antoni Trilla, Mary D. Nettleman +4 more
In large outbreaks involving 10 or more cases, REAP typing data revealed unsuspected patterns of transmission and Restriction endonuclease analysis of plasmid DNA was a practical and valuable adjunct to traditional epidemiological methods.
Infection Control and Hospital EpidemiologyEpidemiologic and Clinical Utility of Typing Systems for Differentiating Among Strains of Methicillin-Resistant <i>Staphylococcus aureus</i>
22 Citations1991Maury E. Mulligan, Robert D. Arbeit
Typing systems for differentiating among strains of methicillin-resistant Staphylococcus aureus (MRSA) can be valuable tools for the epidemiologist and the clinician, but more widely available typing systems based on phenotypic assays and plasmid analysis have limitations in typeability and/or discriminatory power.
Infection Control and Hospital EpidemiologyEffectiveness of Simple Measures to Control an Outbreak of Nosocomial Methicillin-Resistant <i>Staphylococcus aureus</i> Infections in an Intensive Care Unit
14 Citations1990Marguerite Guiguet, Claire Rekacewicz +4 more
Simple control measures including contact isolation of colonized patients and reinforcement of handwashing practices among personnel were followed by a sharp decrease in the rate of infection and colonization of MRSA nosocomial infections even in immunocompromised cancer patients.
