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Screening for Methicillin-Resistant Staphylococcus aureus Colonization Using Sponges

Published online by Cambridge University Press:  05 January 2015

Chang-Seop Lee ,
Bianca Montalmont ,
Jessica A. O’Hara ,
Alveena Syed ,
Charma Chaussard ,
Traci L. McGaha ,
Diana L. Pakstis ,
Ju-Hyung Lee ,
Kathleen A. Shutt  and
Yohei Doi
Chang-Seop Lee
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania Department of Internal Medicine and Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea
Bianca Montalmont
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Jessica A. O’Hara
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Alveena Syed
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Charma Chaussard
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Traci L. McGaha
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Diana L. Pakstis
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Ju-Hyung Lee
Affiliation:
Department of Prevent Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea
Kathleen A. Shutt
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Yohei Doi*
Affiliation:
Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
*
Address correspondence to Yohei Doi, MD, PhD, Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, S829 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261 (yod4@pitt.edu).
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Abstract

OBJECTIVE

Nasal swab culture is the standard method for identifying methicillin-resistant Staphylococcus aureus (MRSA) carriers. However, this method is known to miss a substantial portion of those carrying MRSA elsewhere. We hypothesized that the additional use of a sponge to collect skin culture samples would significantly improve the sensitivity of MRSA detection.

DESIGN

Hospitalized patients with recent MRSA infection were enrolled and underwent MRSA screening of the forehead, nostrils, pharynx, axilla, and groin with separate swabs and the forehead, axilla, and groin with separate sponges. Staphylococcal cassette chromosome mec (SCCmec) typing was conducted by polymerase chain reaction (PCR).

PATIENTS

A total of 105 MRSA patients were included in the study.

RESULTS

At least 1 specimen from 56.2% of the patients grew MRSA. Among patients with at least 1 positive specimen, the detection sensitivities were 79.7% for the swabs and 64.4% for the sponges. Notably, 86.4% were detected by a combination of sponges and nasal swab, and 72.9% were detected by a combination of pharyngeal and nasal swabs, whereas only 50.9% were detected by nasal swab alone (P<0.0001 and P=0.0003, respectively). Most isolates had SCCmec type II (59.9%) and IV (35.7%). No correlation was observed between the SCCmec types and collection sites.

CONCLUSION

Screening using a sponge significantly improves MRSA detection when used in addition to screening with the standard nasal swab.

Infect Control Hosp Epidemiol 2014;36(1): 28–33

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 1 , January 2015 , pp. 28 - 33
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

REFERENCES

1.Wertheim, HF, Melles, DC, Vos, MC, et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis 2005;5:751–762.CrossRefGoogle ScholarPubMed
2.Coello, R, Jimenez, J, Garcia, M, et al. Prospective study of infection, colonization and carriage of methicillin-resistant Staphylococcus aureus in an outbreak affecting 990 patients. Eur J Clin Microbiol Infect Dis 1994;13:74–81.Google Scholar
3.Huang, SS, Platt, R. Risk of methicillin-resistant Staphylococcus aureus infection after previous infection or colonization. Clin Infect Dis 2003;36:281–285.CrossRefGoogle ScholarPubMed
4.Stenstrom, R, Grafstein, E, Romney, M, et al. Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department. CJEM 2009;11:430–438.Google Scholar
5.Thompson, P, Houston, S. Decreasing methicillin-resistant Staphylococcus aureus surgical site infections with chlorhexidine and mupirocin. Am J Infect Control 2013;41:629–633.Google Scholar
6.Sim, BL, McBryde, E, Street, AC, Marshall, C. Multiple site surveillance cultures as a predictor of methicillin-resistant Staphylococcus aureus infections. Infect Control Hosp Epidemiol 2013;34:818–824.CrossRefGoogle ScholarPubMed
7.Harbarth, S, Schrenzel, J, Renzi, G, Akakpo, C, Ricou, B. Is throat screening necessary to detect methicillin-resistant Staphylococcus aureus colonization in patients upon admission to an intensive care unit? J Clin Microbiol 2007;45:1072–1073.CrossRefGoogle Scholar
8.Hambraeus, A, Hoborn, J, Whyte, W. Skin sampling-validation of a pad method and comparison with commonly used methods. J Hosp Infect 1990;16:19–27.Google Scholar
9.Doi, Y, Onuoha, EO, Adams-Haduch, JM, et al. Screening for Acinetobacter baumannii colonization by use of sponges. J Clin Microbiol 2011;49:154–158.Google Scholar
10.Marschall, J, Muhlemann, K. Duration of methicillin-resistant Staphylococcus aureus carriage, according to risk factors for acquisition. Infect Control Hosp Epidemiol 2006;27:1206–1212.Google Scholar
11.Lim, MS, Marshall, CL, Spelman, D. Carriage of multiple subtypes of methicillin-resistant Staphylococcus aureus by intensive care unit patients. Infect Control Hosp Epidemiol 2006;27:1063–1067.Google Scholar
12.Van Vaerenbergh, K, Cartuyvels, R, Coppens, G, Frans, J, Van den Abeele, AM, De Beenhouwer, H, Group, B. Performance of a new chromogenic medium, BBL CHROMagar MRSA II (BD), for detection of methicillin-resistant Staphylococcus aureus in screening samples. J Clin Microbiol 2010;48:1450–1451.Google Scholar
13.Kondo, Y, Ito, T, Ma, XX, et al. Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: rapid identification system for mec, ccr, and major differences in junkyard regions. Antimicrob Agents Chemother 2007;51:264–274.CrossRefGoogle ScholarPubMed
14.von Eiff, C, Becker, K, Machka, K, Stammer, H, Peters, G. Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group. N Engl J Med 2001;344:11–16.CrossRefGoogle ScholarPubMed
15.Wertheim, HF, Vos, MC, Ott, A, van Belkum, A, et al. Risk and outcome of nosocomial Staphylococcus aureus bacteraemia in nasal carriers versus non-carriers. Lancet 2004;364:703–705.Google Scholar
16.Keene, A, Vavagiakis, P, Lee, MH, et al. Staphylococcus aureus colonization and the risk of infection in critically ill patients. Infect Control Hosp Epidemiol 2005;26:622–628.Google Scholar