Interindividual Contacts and Carriage of Methicillin-Resistant Staphylococcus aureus: A Nested Case-Control Study. (20th April 2015)

• Record Type: Journal Article
• Authors: Obadia, Thomas; Opatowski, Lulla; Temime, Laura; Herrmann, Jean-Louis; Fleury, Éric; Boëlle, Pierre-Yves; Guillemot, Didier
• Is Part Of: Infection control and hospital epidemiology. Volume 36:Number 8(2015)
• Page Start: 922
• Page End: 929
• Publication Date: 2015-04-20
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2015.89
• Languages: English
• ISSNs: 0899-823X

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="abs1" sec-type="general"> <title>BACKGROUND</title> <p>Reducing the spread of multidrug-resistant bacteria in hospitals remains a challenge. Current methods are screening of patients, isolation, and adherence to hygiene measures among healthcare workers (HCWs). More specific measures could rely on a better characterization of the contacts at risk of dissemination.</p> </sec> <sec id="abs2" sec-type="general"> <title>OBJECTIVE</title> <p>To quantify how close-proximity interactions (CPIs) affected <italic>Staphylococcus aureus</italic> dissemination.</p> </sec> <sec id="abs3" sec-type="general"> <title>DESIGN</title> <p>Nested case-control study.</p> </sec> <sec id="abs4" sec-type="general"> <title>SETTING</title> <p>French long-term care facility in 2009.</p> </sec> <sec id="abs5" sec-type="general"> <title>PARTICIPANTS</title> <p>Patients (n=329) and HCWs (n=261).</p> </sec> <sec id="abs6" sec-type="methods"> <title>METHODS</title> <p>We recorded CPIs using electronic devices together with <italic>S. aureus</italic> nasal carriage during 4 months in all participants. Cases consisted of patients showing incident <italic>S. aureus</italic> colonization and were paired to 8 control patients who did not exhibit incident colonization at the same date. Conditional logistic regression was used to quantify associations between incidence and exposure to demographic, network, and carriage covariables.</p> </sec> <sec id="abs7" sec-type="results"> <title>RESULTS</title> <p>The local structure of contacts informed on methicillin-resistant <italic>S. aureus</italic> (MRSA) carriage acquisition: CPIs with more HCWs were associated with incident MRSA colonization in patients (odds ratio [OR], 1.10 [95% CI, 1.04–1.17] for 1 more HCW), as well as longer CPI durations (1.03 [1.01–1.06] for a 1-hour increase). Joint analysis of carriage and contacts showed increased carriage acquisition in case of CPI with another colonized individual (OR, 1.55 [1.14–2.11] for 1 more HCW). Global network measurements did not capture associations between contacts and carriage.</p> </sec> <sec id="abs8" sec-type="conclusions"> <title>CONCLUSIONS</title> <p>Electronically recorded CPIs inform on the risk of MRSA carriage, warranting more study of in-hospital contact networks to design targeted intervention strategies.</p> <p> <italic>Infect. Control Hosp. Epidemiol.</italic> 2015;36(8):922–929</p> </sec> </abstract>