Epidemiological analysis of methicillin-resistant Staphylococcus aureus ina Zagreb Trauma Hospital using a randomly amplified polymorphic DNA-typingmethod
A. Tambic et al., Epidemiological analysis of methicillin-resistant Staphylococcus aureus ina Zagreb Trauma Hospital using a randomly amplified polymorphic DNA-typingmethod, EUR J CL M, 18(5), 1999, pp. 335-340
Citations number
26
Categorie Soggetti
Microbiology
Journal title
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
During a 1-month period in 1996, all inpatients and staff in the Zagreb Tra
uma Hospital were screened for methicillin-resistant Staphylococcus aureus
(MRSA) carriage in order to control MRSA spread within the hospital. During
the study period, 663 patients were admitted to the hospital, and screenin
g prior to discharge revealed that 42 were colonised or infected with MRSA,
Twenty-three (55%) of these would not have been detected if active screeni
ng had not been performed. Amongst 205 staff members, MRSA carriage was onl
y found in one (0.5%) nurse. The prevalence and incidence of MRSA carriage
varied significantly amongst the wards and was related to the length of hos
pital stay. One-third of the patients colonised or infected with MRSA had a
history of previous admission to another hospital, and one-third were tran
sferred to another institution after discharge. Thirty-nine of 42 MRSA isol
ates shared the same antibiotic sensitivity pattern, suggesting endemic spr
ead of MRSA. However, randomly amplified polymorphic DNA molecular typing r
evealed four profiles, the most common involving 15 of 36 tested strains. T
here was no obvious clustering of epidemiological types by ward, except for
the appearance of a single type on the burns unit, and it was likely that
different strains had been introduced into the hospital by patient transfer
s from elsewhere. The results of this study indicate that a substantial pro
portion of MRSA carriers escape infection control measures if active screen
ing is not performed. Based on the results of this study, steps have been t
aken to improve interhospital communication about the transfer of patients
colonised with MRSA. Randomly amplified polymorphic DNA typing proved to be
a useful aid to epidemiological investigations of MRSA.