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Article: Increase in methicillin-resistant Staphylococcus aureus acquisition rate and change in pathogen pattern associated with an outbreak of severe acute respiratory syndrome

TitleIncrease in methicillin-resistant Staphylococcus aureus acquisition rate and change in pathogen pattern associated with an outbreak of severe acute respiratory syndrome
Authors
Issue Date2004
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 2004, v. 39 n. 4, p. 511-516 How to Cite?
AbstractBackground. An outbreak of severe acute respiratory syndrome (SARS) occurred in our 22-bed intensive care unit (ICU; Prince of Wales Hospital, Hong Kong, HKSAR, China) from 12 March to 31 May 2003, when only patients with SARS were admitted. This period was characterized by the upgrading of infection control precautions, which included the wearing of gloves and gowns all the time, an extensive use of steroids, and a change in antibiotic prescribing practices. The pattern of endemic pathogenic organisms, the rates of acquisition of methicillin-resistant Staphylococcus aureus (MRSA), and the rates of ventilator-associated pneumonia (VAP) were compared with those of the pre-SARS and post-SARS periods. Methods. Data on pathogenic isolates were obtained from the microbiology department (Prince of Wales Hospital). Data on MRSA acquisition and VAP rates were collected prospectively. MRSA screening was performed for all ICU patients. A case of MRSA carriage was defined as an instance in which MRSA was recovered from any site in a patient, and cases were classified as imported or ICU-acquired if the first MRSA isolate was recovered within 72 h of ICU admission or after 72 h in the ICU, respectively. Results. During the SARS period in the ICU, there was an increase in the rate of isolation of MRSA and Stenotrophomonas and Candida species but a disappearance of Pseudomonas and Klebsiella species. The MRSA acquisition rate was also increased: it was 3.53% (3.53 cases per 100 admissions) during the pre-SARS period, 25.30% during the SARS period, and 2.21% during the post-SARS period (P < .001). The VAP rate was high, at 36.5 episodes per 1000 ventilator-days, and 47% of episodes were caused by MRSA. Conclusions. A SARS outbreak in the ICU led to changes in the pathogen pattern and the MRSA acquisition rate. The data suggest that MRSA cross-transmission may be increased if gloves and gowns are worn all the time.
Persistent Identifierhttp://hdl.handle.net/10722/42161
ISSN
2015 Impact Factor: 8.736
2015 SCImago Journal Rankings: 4.742
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYap, FHYen_HK
dc.contributor.authorGomersall, CDen_HK
dc.contributor.authorFung, KSCen_HK
dc.contributor.authorHo, PLen_HK
dc.contributor.authorHo, OMen_HK
dc.contributor.authorLam, PKNen_HK
dc.contributor.authorLam, DTCen_HK
dc.contributor.authorLyon, DJen_HK
dc.contributor.authorJoynt, GMen_HK
dc.date.accessioned2007-01-08T02:30:35Z-
dc.date.available2007-01-08T02:30:35Z-
dc.date.issued2004en_HK
dc.identifier.citationClinical Infectious Diseases, 2004, v. 39 n. 4, p. 511-516en_HK
dc.identifier.issn1058-4838en_HK
dc.identifier.urihttp://hdl.handle.net/10722/42161-
dc.description.abstractBackground. An outbreak of severe acute respiratory syndrome (SARS) occurred in our 22-bed intensive care unit (ICU; Prince of Wales Hospital, Hong Kong, HKSAR, China) from 12 March to 31 May 2003, when only patients with SARS were admitted. This period was characterized by the upgrading of infection control precautions, which included the wearing of gloves and gowns all the time, an extensive use of steroids, and a change in antibiotic prescribing practices. The pattern of endemic pathogenic organisms, the rates of acquisition of methicillin-resistant Staphylococcus aureus (MRSA), and the rates of ventilator-associated pneumonia (VAP) were compared with those of the pre-SARS and post-SARS periods. Methods. Data on pathogenic isolates were obtained from the microbiology department (Prince of Wales Hospital). Data on MRSA acquisition and VAP rates were collected prospectively. MRSA screening was performed for all ICU patients. A case of MRSA carriage was defined as an instance in which MRSA was recovered from any site in a patient, and cases were classified as imported or ICU-acquired if the first MRSA isolate was recovered within 72 h of ICU admission or after 72 h in the ICU, respectively. Results. During the SARS period in the ICU, there was an increase in the rate of isolation of MRSA and Stenotrophomonas and Candida species but a disappearance of Pseudomonas and Klebsiella species. The MRSA acquisition rate was also increased: it was 3.53% (3.53 cases per 100 admissions) during the pre-SARS period, 25.30% during the SARS period, and 2.21% during the post-SARS period (P < .001). The VAP rate was high, at 36.5 episodes per 1000 ventilator-days, and 47% of episodes were caused by MRSA. Conclusions. A SARS outbreak in the ICU led to changes in the pathogen pattern and the MRSA acquisition rate. The data suggest that MRSA cross-transmission may be increased if gloves and gowns are worn all the time.en_HK
dc.format.extent133274 bytes-
dc.format.extent4522 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypetext/plain-
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/en_HK
dc.relation.ispartofClinical Infectious Diseasesen_HK
dc.rightsClinical Infectious Diseases. Copyright © University of Chicago Press.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAnti-bacterial agentsen_HK
dc.subject.meshDisease outbreaksen_HK
dc.subject.meshDrug resistance, bacterialen_HK
dc.subject.meshEnvironmental monitoringen_HK
dc.subject.meshInfection controlen_HK
dc.titleIncrease in methicillin-resistant Staphylococcus aureus acquisition rate and change in pathogen pattern associated with an outbreak of severe acute respiratory syndromeen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1058-4838&volume=39&issue=4&spage=511&epage=516&date=2004&atitle=Increase+in+methicillin-resistant+Staphylococcus+aureus+acquisition+rate+and+change+in+pathogen+pattern+associated+with+an+outbreak+of+severe+acute+respiratory+syndromeen_HK
dc.identifier.emailHo, PL:plho@hkucc.hku.hken_HK
dc.identifier.authorityHo, PL=rp00406en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1086/422641en_HK
dc.identifier.pmid15356814en_HK
dc.identifier.scopuseid_2-s2.0-4344623489en_HK
dc.identifier.hkuros106008-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-4344623489&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume39en_HK
dc.identifier.issue4en_HK
dc.identifier.spage511en_HK
dc.identifier.epage516en_HK
dc.identifier.isiWOS:000223141500013-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYap, FHY=7003400949en_HK
dc.identifier.scopusauthoridGomersall, CD=7003857368en_HK
dc.identifier.scopusauthoridFung, KSC=8948874600en_HK
dc.identifier.scopusauthoridHo, PL=7402211363en_HK
dc.identifier.scopusauthoridHo, OM=6603584958en_HK
dc.identifier.scopusauthoridLam, PKN=20434326600en_HK
dc.identifier.scopusauthoridLam, DTC=7201749668en_HK
dc.identifier.scopusauthoridLyon, DJ=7102554823en_HK
dc.identifier.scopusauthoridJoynt, GM=7005588815en_HK

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