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A community hospital's rate of MRSA bloodstream infections is much higher than the national rate. Would you know what to do to reverse this trend?
The cobas vivoDx MRSA test uses a new bacteriophage technology based on bioluminescence to detect MRSA from nasal swab samples in 5 hours or less compared with 24 to 48 hours for conventional cultures.
During 2014--2017, CDC Emerging Infections Program surveillance data reported that the occurrence of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections associated with injection drug use doubled among persons aged 18--49 years residing in Monroe County in western New York.
Staphylococcus aureus is among the most common causes of health care-associated infections and accounts for significant morbidity and mortality. Beginning in 2005, in response to high rates of methicillin-resistant S. aureus (MRSA) infections, the U.S. Department of Veterans Affairs (VA) piloted an MRSA prevention program in 18 VA medical centers (VAMCs).
Staphylococcus aureus is a major cause of community- and health care-associated infections, ranging from superficial skin and soft tissue infections (SSTI) to invasive infections, sepsis, and death. Methicillin-resistant S. aureus (MRSA) has long been recognized as a pathogen associated with health care settings; however, in the 1990s, community-associated MRSA infections, causing mostly SSTI, emerged in the United States.
Jens Kjølseth Møller, Anders Rhod Larsen, Claus Østergaard, Camilla Holten Møller, Mette Assenholm Kristensen and Jesper Larsen
In May 2016, an unusual outbreak with the Panton-Valentine leukocidin-positive human variant of meticillin-resistant Staphylococcus aureus (MRSA) clonal complex 398 occurred among mothers and infants in the maternity unit of a Danish hospital. MRSA sharing genotypic and phenotypic characteristics was confirmed in 36 cases, including 26 patients, nine household members and a healthcare worker (HCW) who had contact with all the patients. The national MRSA database contained 37 seemingly unlinked MRSA cases whose isolates shared the same genotypic and phenotypic characteristics as the outbreak strain. Whole genome sequencing showed that three of these isolates clustered together with the 36 outbreak isolates, suggesting spread outside the hospital. The HCW and 21 of 37 cases from the national MRSA database had links to south-eastern Asia, where the outbreak strain is endemic. These findings suggest that the HCW acquired the outbreak strain while travelling in south-eastern Asia and then introduced it into the hospital; from there, it spread within the patients’ households and into the community. Screening of travellers returning from countries with high levels of MRSA could be an important intervention to prevent spread of these bacteria into hospitals via patients or HCWs.
Annette Jurke, Inka Daniels-Haardt, Welmoed Silvis, Matthijs S. Berends, Corinna Glasner, Karsten Becker, Robin Köck and Alex W. Friedrich
Meticillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections.
We describe MRSA colonisation/infection and bacteraemia rate trends in Dutch–German border region hospitals (NL–DE-BRH) in 2012–16.
All 42 NL–DE BRH (8 NL-BRH, 34 DE-BRH) within the cross-border network EurSafety Health-net provided surveillance data (on average ca 620,000 annual hospital admissions, of these 68.0% in Germany). Guidelines defining risk for MRSA colonisation/infection were reviewed. MRSA-related parameters and healthcare utilisation indicators were derived. Medians over the study period were compared between NL- and DE-BRH.
Measures for MRSA cases were similar in both countries, however defining patients at risk for MRSA differed. The rate of nasopharyngeal MRSA screening swabs was 14 times higher in DE-BRH than in NL-BRH (42.3 vs 3.0/100 inpatients; p
Simon Packer, Bruno Pichon, Stephen Thompson, Jane Neale, Jacquelyn Njoroge, Rachel M Kwiatkowska, Isabel Oliver, Maggie Telfer, Michel Doumith, Camillus Buunaaisie, Ellen Heinsbroek, Noreen Hopewell-Kelly, Monica Desai, Vivian Hope, Owen Martin Williams, Angela Kearns, Mathew Hickman and Maya Gobin
Background: In 2015, Bristol (South West England) experienced a large increase in cases of meticillin-resistant Staphylococcus aureus (MRSA) infection in people who inject drugs (PWID).
Aim: We aimed to characterise and estimate the prevalence of MRSA colonisation among PWID in Bristol and test evidence of a clonal outbreak.
Methods: PWID recruited through an unlinked-anonymous community survey during 2016 completed behavioural questionnaires and were screened for MRSA. Univariable logistic regression examined associations with MRSA colonisation. Whole-genome sequencing used lineage-matched MRSA isolates, comparing PWID (screening and retrospective bacteraemia samples from 2012-2017) with non-PWID (Bristol screening) in Bristol and national reference laboratory database samples.
Results: The MRSA colonisation prevalence was 8.7% (13/149) and was associated with frequently injecting in public places (odds ratio (OR): 5.5; 95% confidence interval (CI):1.34–22.70), recent healthcare contact (OR: 4.3; 95% CI: 1.34–13.80) and injecting in groups of three or more (OR: 15.8; 95% CI: 2.51–99.28). People reporting any one of: injecting in public places, injection site skin and soft tissue infection or hospital contact accounted for 12/13 MRSA positive cases (sensitivity 92.3%; specificity 51.5%). Phylogenetic analysis identified a dominant clade associated with infection and colonisation among PWID in Bristol belonging to ST5-SCCmecIVg.
Conclusions: MRSA colonisation in Bristol PWID is substantially elevated compared with general population estimates and there is evidence of clonal expansion, community-based transmission and increased infection risk related to the colonising strain. Targeted interventions, including community screening and suppression therapy, education and basic infection control are needed to reduce MRSA infections in PWID.
MRSA, Antimicrobial resistance -- Worldwide/UnknownAn analysis of human isolates from 19 EU nations, plus Iceland and Norway, found that 57.7% of _Campylobacter jejuni_ -- the commonest _Campylobacter_ species identified -- were resistant to ciprofloxacin, and 45.4% were resistant to tetracyclines. Resistance to erythromycin was low (2%).In Cyprus, Portugal, Spain, Lithuania, and Estonia, resistance to ciprofloxacin was from 80% to 96.5%. In addition, 8 of 17 countries saw a statistically significant increase in ciprofloxacin resistance
A new study finds that decolonization of MRSA carriers following discharge from the hospital can reduce the risk of developing an infection in the subsequent year.
Michelle S Toleman, Sandra Reuter, Dorota Jamrozy, Hayley J Wilson, Beth Blane, Ewan M Harrison, Francesc Coll, Russell J Hope, Angela Kearns, Julian Parkhill, Sharon J Peacock and M Estée Török
Mandatory reporting of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) has occurred in England for over 15years. Epidemiological information is recorded, but routine collection of isolates for characterisation has not been routinely undertaken. Ongoing developments in whole-genome sequencing (WGS) have demonstrated its value in outbreak investigations and for determining the spread of antimicrobial resistance and bacterial population structure. Benefits of adding genomics to routine epidemiological MRSA surveillance are unknown.
To determine feasibility and potential utility of adding genomics to epidemiological surveillance of MRSA.
We conducted an epidemiological and genomic survey of MRSA BSI in England over a 1-year period (1 October 2012–30 September 2013).
During the study period, 903 cases of MRSA BSI were reported; 425 isolates were available for sequencing of which, 276 (65%) were clonal complex (CC) 22. Addition of 64 MRSA genomes from published outbreak investigations showed that the study genomes could provide context for outbreak isolates and supported cluster identification. Comparison to other MRSA genome collections demonstrated variation in clonal diversity achieved through different sampling strategies and identified potentially high-risk clones e.g. USA300 and local expansion of CC5 MRSA in South West England.
We demonstrate the potential utility of combined epidemiological and genomic MRSA BSI surveillance to determine the national population structure of MRSA, contextualise previous MRSA outbreaks, and detect potentially high-risk lineages. These findings support the integration of epidemiological and genomic surveillance for MRSA BSI as a step towards a comprehensive surveillance programme in England.
Monkeypox, Hepatitis B, Other Human Disease, Tuberculosis, Zika virus, HIV/AIDS, Rubella, Measles, MRSA, Crimean-Congo Hemorrhagic Fever, Chagas -- NigeriaEditorials and perspectivesMonkeypox -- Enhancing public health preparedness for an emerging lethal human zoonotic epidemic threat in the wake of the smallpox post-eradication eraEskild Petersen, Ibrahim Abubakar, Chikwe Ihekweazu, David Heymann, Francine Ntoumi, Lucille Blumberg, Danny Asogun, Victor Mukonka, Swaib Abubaker Lule, Matthew Bates, Isobella Honeyborne, Sayoki Mfinanga, Peter Mwaba, Osman Dar, Francesco Vairo, Maowia Mukhtar, Richard Kock, Timothy D. McHugh, Giuseppe Ippolito,
Et nyt studie, som Statens Serum Institut har deltaget i, har påvist en mekanisme, hvor visse typer af MRSA kan skjule sig for immunforsvaret.
Referencelaboratoriet for Antibiotikaresistens og Stafylokokker pÃ¥ Statens Serum Institut opgÃ¸r hvert kvartal antallet af blodforgiftninger forÃ¥rsaget af MRSA samt dÃ¸dsfald som fÃ¸lge af disse.
Den Ã¸gede forekomst af husdyr-MRSA i danske svin skyldes tre succesfulde undertyper, der er resistente over for en rÃ¦kke hyppigt anvendte antibiotika i svineproduktionen. Desuden har handel med svin spillet en vigtig rolle i spredningen af husdyr-MRSA mellem besÃ¦tningerne. Det viser et nyt studie fra Statens Serum Institut og Danmarks Tekniske Universitet.Â
Tuomas Aro and Anu Kantele
Antimicrobial resistance is increasing rapidly in countries with low hygiene levels and poorly controlled antimicrobial use. The spread of resistant bacteria poses a threat to healthcare worldwide. Refugees and migrants from high-prevalence countries may add to a rise in multidrug-resistant (MDR) bacteria in low-prevalence countries. However, respective data are scarce.
We retrospectively collected microbiological and clinical data from asylum seekers and refugees treated at Helsinki University Hospital between January 2010 and August 2017.
Of 447 asylum seekers and refugees (Iraq: 46.5%; Afghanistan: 10.3%; Syria: 9.6%, Somalia: 6.9%); 45.0% were colonised by MDR bacteria: 32.9% had extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE), 21.3% meticillin-resistant Staphylococcus aureus (MRSA), 0.7% carbapenemase-producing Enterobacteriaceae (CPE), 0.4% multiresistant Pseudomonas aeruginosa (MRPA), 0.4% multiresistant Acinetobacter baumannii (MRAB); no vancomycin-resistant Enterococcus (VRE) were found. Two or more MDR bacteria strains were recorded for 12.5% of patients. Multivariable analysis revealed geographical region and prior surgery outside Nordic countries as risk factors of MRSA colonisation. Young age (
Specialespecifikt kursus om immundefekt og feber af ukendt årsag
28.01.2020 - 29.01.2020
International Congress on Infectious Diseases (ICID) 2020
Kuala Lumpur, Malaysia
20.02.2020 - 23.02.2020
Dansk Selskab for Intern Medicin (DSIM) årsmøde og overrækkelse af Hagedorn prisen 2020
Novo Nordisk Fonden, Tuborg Havnevej 19, 2900 Hellerup
Conference on Retroviruses and Opportunistic Infections (CROI) 2020
Boston, Massachusetts, USA
8.03.2020 - 11.03.2020
Når CROI går i fisk - med transmissioner fra CROI 2020
10.03.2020 - 11.03.2020
Retningslinjer til sundhedsprofessionelle vedr. håndtering af infektion med zikavirus (2019)
Antiviral behandling af hiv smittede personer (2019)
Lumbalpunktur af patienter i blodfortyndende behandling (2019)
How to Choose Target Facilities in a Region to Implement Carbapenem-Resistant Enterobacteriaceae (CRE) Control Measures
23.01.2020Clinical Infectious Diseases Advance Access
Evaluation of Genotypic Antiviral Resistance Testing as an Alternative to Phenotypic Testing in a Patient with DOCK8 Deficiency and Severe HSV-1 Disease
23.01.2020The Journal of Infectious Diseases Advance Access
Bronchiectasis;a progressive phenotype of Chronic Obstructive Pulmonary Disease
22.01.2020Clinical Infectious Diseases Advance Access
BRONCHIAL INFECTION AND temporal evolution OF bronchiectasis in patients with chronic obstructive pulmonary disease
22.01.2020Clinical Infectious Diseases Advance Access
More Screening or More Disease? Gonorrhea Testing and Positivity Patterns among Men in Three Large Clinical Practices in Massachusetts, 2010-2017
22.01.2020Clinical Infectious Diseases Advance Access
Hvorfor anbefaler Professor Jens Lundgren artiklen"Dolutegravir plus Two Different Prodrugs of Tenofovir to Treat HIV."?
Hvad tænker Professor Troels Lillebæk om"The global prevalence of latent tuberculosis: a systematic review and meta-analysis."?
Hvad synes Professor Lars Østergaard om"Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial."?
Hvad mener Professor Thomas Benfield om artiklen"Oral versus Intravenous Antibiotics for Bone and Joint Infection."?
Hvorfor synes Professor Niels Obel, at du bør læse"Early, Goal-Directed Therapy for Septic Shock - A Patient-Level Meta-Analysis."?
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