Details:

Alternative Title:
Infect Control Hosp Epidemiol
Publisher's site:
http://dx.doi.org/10.1086/671735
Personal Author:
Tosh, Pritish K. ; Agolory, Simon ; Strong, Bethany L. ; VerLee, Kerrie ; Finks, Jennie ; ... More +
Tosh, Pritish K. ; Agolory, Simon ; Strong, Bethany L. ; VerLee, Kerrie ; Finks, Jennie ; Hayakawa, Kayoko ; Chopra, Teena ; Kaye, Keith S. ; Gilpin, Nicholas ; Carpenter, Christopher F. ; Haque, Nadia Z. ; Lamarato, Lois E. ; Zervos, Marcus J. ; Albrecht, Valerie S. ; McAllister, Sigrid K. ; Limbago, Brandi ; MacCannell, Duncan R. ; McDougal, Linda K. ; Kallen, Alexander J. ; Guh, Alice Y. Less -
Description:
BACKGROUND

Of the 13 US vancomycin-resistant Staphylococcus aureus (VRSA) cases, 8 were identified in southeastern Michigan, primarily in patients with chronic lower-extremity wounds. VRSA infections develop when the vanA gene from vancomycin-resistant enterococcus (VRE) transfers to S. aureus. Inc18-like plasmids in VRE and pSK41-like plasmids in S. aureus appear to be important precursors to this transfer.

OBJECTIVE

Identify the prevalence of VRSA precursor organisms.

DESIGN

Prospective cohort with embedded case-control study.

PARTICIPANTS

Southeastern Michigan adults with chronic lower-extremity wounds.

METHODS

Adults presenting to 3 southeastern Michigan medical centers during the period February 15 through March 4, 2011, with chronic lower-extremity wounds had wound, nares, and perirectal swab specimens cultured for S. aureus and VRE, which were tested for pSK41-like and Inc18-like plasmids by polymerase chain reaction. We interviewed participants and reviewed clinical records. Risk factors for pSK41-positive S. aureus were assessed among all study participants (cohort analysis) and among only S. aureus-colonized participants (case-control analysis).

RESULTS

Of 179 participants with wound cultures, 26% were colonized with methicillin-susceptible S. aureus, 27% were colonized with methicillin-resistant S. aureus, and 4% were colonized with VRE, although only 17% consented to perirectal culture. Six participants (3%) had pSK41-positive S. aureus, and none had Inc18-positive VRE. Having chronic wounds for over 2 years was associated with pSK41-positive S. aureus colonization in both analyses.

CONCLUSIONS

Colonization with VRSA precursor organisms was rare. Having long-standing chronic wounds was a risk factor for pSK41-positive S. aureus colonization. Additional investigation into the prevalence of VRSA precursors among a larger cohort of patients is warranted.


Subject:
[+]
Adult
Aged
Aged, 80 And Over
Female
Humans
Leg Injuries
Male
Middle Aged
Prevalence
Risk Factors
Staphylococcal Infections
Vancomycin Resistance
Wound Infection

Source:
Infect Control Hosp Epidemiol. 34(9):954-960
Pubmed ID:
23917910
Pubmed Central ID:
PMC6489131
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Place as Subject:
Michigan
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:27a35a18ea8ebf8dbed81881e0850e749500922cc7bf2d7b83279c55b4021622
File Type:

Supporting Files

• nihms-1025157.nxml

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