Methicillin-resistant Staphylococcus aureus (MRSA) carriage in a dermatology unit

Autor(es):Mostrar menos -

Pacheco, Renata L. ^{[1, 2]} ; Lobo, Renata D. ^[3] ; Oliveira, Maura S. ^[3] ; Farina, Elthon F. ^{[1, 2]} ; Santos, Cleide R. ^[3] ; Costa, Silvia F. ^{[1, 2]} ; Padoveze, Maria Clara ^[4] ; Garcia, Cilmara P. ^[3] ; Trindade, Priscila A. ^{[1, 2]} ; Quiterio, Ligia M. ^{[5, 6]} ; Rivitti, Evandro A. ^{[5, 6]} ; Mamizuka, Elsa M. ^[7] ; Levin, Anna S. ^{[1, 2, 3]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med, Dept Infect Dis, Hosp Clin, Sao Paulo - Brazil

^[2] LIM 54, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, Dept Infect Control Sao Paulo, Hosp Clin, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Sch Nursing, Dept Collect Hlth, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Fac Med, Dept Dermatol, Hosp Clin, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Fac Med, Div Dermatol, Hosp Clin, Sao Paulo - Brazil

^[7] Univ Sao Paulo, Fac Ciencias Farmaceut, Dept Clin Anal, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Clinics; v. 66, n. 12, p. 2071-2077, 2011.
• Citações Web of Science: 17

Resumo

OBJECTIVE: The aim of this study was to characterize Staphylococcus aureus (MRSA) carriage in a dermatology unit. METHODS: This was a prospective and descriptive study. Over the course of 26 weeks, surveillance cultures were collected weekly from the anterior nares and skin of all patients hospitalized in a 20-bed dermatology unit of a tertiary-care hospital. Samples from healthcare workers (HCWS) were cultured at the beginning and end of the study. Colonized patients were put under contact precautions, and basic infection control measures were enforced. Staphylococcus aureus colonization pressure was determined monthly. Colonized and non-colonized patients were compared, and isolates were evaluated for antimicrobial susceptibility, SCCmec type, virulence factors, and type. RESULTS: Of the 142 patients evaluated, 64 (45%) were colonized by MRSA (39% hospital acquired; 25% community acquired; 36% indeterminate). Despite isolation precautions, hospital-acquired Staphylococcus aureus occurred in addition to the continuous entry of Staphylococcus aureus from the community. Colonization pressure increased from 13% to 59%, and pemphigus and other bullous diseases were associated with MRSA colonization. Eleven out of 71 HCWs (15%) were Staphylococcus aureus carriers, although only one worker carried a persistent clone. Of the hospital-acquired MRSA cases, 14/28 (50%) were SCCmec type IV (3 PFGE types), 13 were SCCmec type III (46%), and one had an indeterminate type. These types were also present among the community-acquired Staphylococcus aureus isolates. SSCmec type IV isolates were shown to be more susceptible than type III isolates. There were two cases of bloodstream infection, and the pvl and tst virulence genes were absent from all isolates. CONCLUSIONS: Dermatology patients were colonized by community- and hospital-acquired Staphylococcus aureus. Half of the nosocomial Staphylococcus aureus isolates were SCCmec type IV. Despite the identification of colonized patients and the subsequent contact precautions and room placement, Staphylococcus aureus colonization continued to occur, and colonization pressure increased. Pemphigus and other bullous diseases were associated with Staphylococcus aureus. (AU)

• Processo FAPESP: 06/03003-7 - Avaliação e controle da disseminação de Staphylococcus aureus resistente à oxacilina em Serviço de Dermatologia do Hospital das Clínicas
• Beneficiário: Anna Sara Shafferman Levin
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 06/00569-0 - Avaliação de fatores associados à colonização nasal por Staphylococcus aureus resistente à oxacilina em pacientes internados em enfermaria de dermatologia
• Beneficiário: Elthon Ferraz Farina
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica