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Volume 9, Number 2—February 2003
Research

Elimination of Epidemic Methicillin-Resistant Staphylococcus aureus from a University Hospital and District Institutions, Finland

Pirkko Kotilainen*†Comments to Author , Marianne Routamaa*, Reijo Peltonen*, Jarmo Oksi*, Esa Rintala‡, Olli Meurman*, Olli-Pekka Lehtonen*, Erkki Eerola§, Saara Salmenlinna¶, Jaana Vuopio-Varkila¶, and Tuire Rossi*
Author affiliations: *Turku University Central Hospital, Turku, Finland; †National Public Health Institute, Turku, Finland; ‡Satakunta Central Hospital, Pori, Finland; §Turku University, Turku, Finland; ¶National Public Health Institute, Helsinki, Finland

Main Article

Table

Yearly number of new cases caused by different methicillin-resistant Staphylococcus aureus (MRSA) strains, Southwest Finland Medical District, 1991–2000

Year Strains
Surgical outbreaka Medical outbreakb Mynamaki
outbreakc MRSA outbreak IVd MRSA outbreak Ve Other outbreaks Familial MRSAf Solitary MRSA Total
1991
 11
2
 13
1992
 19
 56
2g
1
 78
1993
 1
 1
 13
 4
2h
 2
 4
 27
1994
3
 2
 5
1995
 4
3
 7
1996
 2
7
 9
1997
2
 6
 8
1998
2g
17
 19
1999
2g
 2
 10
 14
2000
5
 2g
 4
 11
 22
Total 37 57 13 4 5 10 13 63 202

aStrain was recovered from 24 patients at the university hospital,10 patients at a regional hospital, and 3 staff members in these hospitals.

bStrain was recovered from 30 patients and 18 staff members at the university hospital and from 9 patients in other district institutions.

cStrain was recovered from 12 patients and 1 staff member in a health-center ward and associated nursing home (7).

dStrain caused a cluster of four cases in an intensive-care unit of a central hospital.

eStrain caused a cluster of four infected patients and one infected staff member in a health-center ward at the beginning of 2000, but was subsequently eliminated.

fIntrafamilial clusters of two to four MRSA cases in the community.

gMRSA strain was transmitted from one patient to another at the university hospital.

hMRSA strain was transmitted from one patient to another at a regional hospital.

Main Article

References
  1. Diekema  DJ, Pfaller  MA, Schmitz  FJ, Smayevsky  J, Bell  J, Jones  RN, Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific Region for the SENTRY antimicrobial surveillance program, 1997–1999. Clin Infect Dis. 2001;32(Suppl 2):114–32. DOIGoogle Scholar
  2. Verhoef  J, Beaujean  D, Blok  H, Baars  A, Meyler  A, van der Werken  C, A Dutch approach to methicillin-resistant Staphylococcus aureus. Eur J Clin Microbiol Infect Dis. 1999;18:461–6. DOIPubMedGoogle Scholar
  3. Pittet  D, Hugonnet  S, Harbarth  S, Mourouga  P, Sauvan  V, Touveneau  S, Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet. 2000;356:1307–12. DOIPubMedGoogle Scholar
  4. Voss  A, Milatovic  D, Wallrauch-Schwarz  C, Rosdahl  VT, Braveny  I. Methicillin-resistant Staphylococcus aureus in Europe. Eur J Clin Microbiol Infect Dis. 1994;13:50–5. DOIPubMedGoogle Scholar
  5. Hyvärinen  J, Huovinen  P, Järvinen  H, Kotilainen  P. Multiresistance in Staphylococcus spp. blood isolates in Finland with special reference to the distribution of the mecA gene among the Staphylococcus epidermidis isolates. APMIS. 1995;103:885–91. DOIPubMedGoogle Scholar
  6. Salmenlinna  S, Lyytikäinen  O, Kotilainen  P, Scotford  R, Siren  E, Vuopio-Varkila  J. Molecular epidemiology of methicillin-resistant Staphylococcus aureus in Finland. Eur J Clin Microbiol Infect Dis. 2000;19:101–7. DOIPubMedGoogle Scholar
  7. Kotilainen  P, Routamaa  M, Peltonen  R, Evesti  P, Eerola  E, Salmenlinna  S, Eradication of methicillin-resistant Staphylococcus aureus from a health center ward and associated nursing home. Arch Intern Med. 2001;161:859–63. DOIPubMedGoogle Scholar
  8. Rossi  T, Peltonen  R, Laine  J, Eerola  E, Vuopio-Varkila  J, Kotilainen  P. Eradication of the long-term carriage of methicillin-resistant Staphylococcus aureus in patients wearing dentures: a follow-up of 10 patients. J Hosp Infect. 1996;34:311–20. DOIPubMedGoogle Scholar
  9. National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disc susceptibility tests. Villanova (PA): The Committee; 1990. Document M2–A4.
  10. Predari  SC, Ligozzi  M, Fontana  R. Genotypic identification of methicillin-resistant coagulase-negative staphylococci by polymerase chain reaction. Antimicrob Agents Chemother. 1991;35:2568–73.PubMedGoogle Scholar
  11. Rossi  T, Laine  J, Eerola  E, Kotilainen  P, Peltonen  R. Denture carriage of methicillin-resistant Staphylococcus aureus [letter]. Lancet. 1995;345:1577. DOIPubMedGoogle Scholar
  12. Aires de Sousa  M, Santos Sanches  I, Ferro  ML, Vaz  MJ, Saraiva  Z, Tendeiro  T, Intercontinental spread of a multidrug-resistant methicillin-resistant Staphylococcus aureus clone. J Clin Microbiol. 1998;36:2590–6.PubMedGoogle Scholar
  13. Couto  I, Melo-Cristino  J, Fernandes  ML, Garcia  T, Serrano  N, Salgado  MJ, Unusually large number of methicillin-resistant Staphylococcus aureus clones in a Portuguese hospital. J Clin Microbiol. 1995;33:2032–5.PubMedGoogle Scholar
  14. Farrington  M, Redpath  C, Trundle  C, Coomber  S, Brown  NM. Winning the battle but losing the war: methicillin-resistant Staphylococcus aureus (MRSA) infection at a teaching hospital. QJM. 1998;91:539–48. DOIPubMedGoogle Scholar
  15. The Hopital Propre II Study Group. Methicillin-resistant Staphylococcus aureus in French hospitals: a 2-month survey in 43 hospitals, 1995. Infect Control Hosp Epidemiol. 1999;20:478–86. DOIPubMedGoogle Scholar
  16. de Lencastre  H, Severina  E, Milch  H, Konkoly Thege  M, Tomasz  A. Wide geographic distribution of a unique methicillin-resistant Staphylococcus aureus clone in Hungarian hospitals. Clin Microbiol Infect. 1997;3:289–96. DOIPubMedGoogle Scholar
  17. Aucken  HM, Ganner  M, Murchan  S, Cookson  BD, Johnson  AP. A new UK strain of epidemic methicillin-resistant Staphylococcus aureus (EMRSA-17) resistant to multiple antibiotics. J Antimicrob Chemother. 2002;50:171–5. DOIPubMedGoogle Scholar
  18. Dancer  SJ, Crawford  A. Keeping MRSA out of a district general hospital. J Hosp Infect. 1999;43(Suppl):19–27. DOIPubMedGoogle Scholar
  19. Herwaldt  LA. Control of methicillin-resistant Staphylococcus aureus in the hospital setting. Am J Med. 1999;106:11–8. DOIPubMedGoogle Scholar
  20. Vandenbroucke-Grauls  CM, Frenay  HME, van Klingeren  B, Savelkoul  TF, Verhoef  J. Control of epidemic methicillin-resistant Staphylococcus aureus in a Dutch university hospital. Eur J Clin Microbiol Infect Dis. 1991;10:6–11. DOIPubMedGoogle Scholar
  21. Jernigan  JA, Titus  MG, Groschel  DH, Getchell-White  S, Farr  BM. Effectiveness of contact isolation during a hospital outbreak of methicillin-resistant Staphylococcus aureus. Am J Epidemiol. 1996;143:496–504.PubMedGoogle Scholar
  22. Karchmer  TB, Durbin  LJ, Simonton  BM, Farr  BM. Cost-effectiveness of active surveillance cultures and contact/droplet precautions for control of methicillin-resistant Staphylococcus aureus. J Hosp Infect. 2002;51:126–32. DOIPubMedGoogle Scholar
  23. Barrett  SP, Mummery  RV, Chattopadhyay  B. Trying to control MRSA causes more problems than it solves. J Hosp Infect. 1998;39:85–93. DOIPubMedGoogle Scholar
  24. Bowler  ICJ. Is control of methicillin-resistant Staphylococcus aureus justified? QJM. 1997;90:243–6. DOIPubMedGoogle Scholar
  25. Pittet  D, Waldvogel  FA. To control or not to control colonization with MRSA...that's the question. QJM. 1997;90:239–41. DOIPubMedGoogle Scholar
  26. Teare  EL, Barrett  SP. Controversies: is it time to stop searching for MRSA? Stop the ritual of tracing colonised people. BMJ. 1997;314:665.PubMedGoogle Scholar
  27. Boyce  JM. Should we vigorously try to contain and control methicillin-resistant Staphylococcus aureus? Infect Control Hosp Epidemiol. 1991;12:46–54. DOIPubMedGoogle Scholar
  28. Working Party report. Revised guidelines for the control of epidemic methicillin-resistant Staphylococcus aureus. J Hosp Infect. 1990;16:351–77. DOIPubMedGoogle Scholar
  29. Ayliffe  GA, Buckles  A, Casewell  MW, Cookson  BD, Cox  RA, Duckworth  GJ, Revised guidelines for control of MRSA: applying appropriately-based recommendations. J Hosp Infect. 1999;43:315–6. DOIPubMedGoogle Scholar
  30. Working Party report. Revised guidelines for the control of methicillin-resistant Staphylococcus aureus infection in hospitals. J Hosp Infect. 1998;39:253–90. DOIPubMedGoogle Scholar
  31. Mulligan  ME, Murray-Leisure  KA, Ribner  BS, Standiford  HC, John  JF, Korvick  JA, Methicillin-resistant Staphylococcus aureus: a consensus review of the microbiology, pathogenesis, and epidemiology with implications for prevention and management. Am J Med. 1993;94:313–28. DOIPubMedGoogle Scholar
  32. Wenzel  RP, Reagan  DR, Bertino  JS, Baron  EJ, Arias  K. Methicillin-resistant Staphylococcus aureus outbreak: a consensus panel's definition and management guidelines. Am J Infect Control. 1998;26:102–10. DOIPubMedGoogle Scholar
  33. Centers for Disease Control and Prevention. Staphylococcus aureus resistant to vancomycin—United States, 2002. MMWR Morb Mortal Wkly Rep. 2002;51:565–7.PubMedGoogle Scholar

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