title: Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization among patients and healthcare workers in a Portuguese hospital: a pre-intervention study toward the control of MRSA.
abstract: This two-year study investigated the epidemiology of nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) among patients and healthcare workers (HCWs) in two wards with a high frequency of MRSA isolation, at Hospital Geral de Santo António (HGSA), Portugal. Three point-prevalence surveys per year were carried out. A case-control approach was used to identify potential risk factors associated with MRSA carriage among patients. Incidence rates and risk factors of MRSA carriage among HCWs who were negative at the baseline observation were estimated. Prevalence of MRSA carriage among 276 patients screened was 5.1%. Admission to HGSA or attendance to the Diabetic Foot Outpatient Unit (DFOU) of HGSA within the past 12 months, and previous MRSA isolation were significant risk factors for MRSA carriage. Among HCWs (n = 126), the prevalence of MRSA carriage was 4.8% and the incidence rate was 61/1000 person-years. Nurses and nurse aids were the HCW categories with the highest risk of becoming colonized with MRSA over time (p = 0.01). One HCW chronically colonized was detected. Molecular typing revealed a clonal identity for isolates recovered from patients and HCWs of the same wards, with 88.6% of isolates belonging to the EMRSA-15 (ST22-MRSA-IV) clone.
authors.affiliation: Laboratório of Molecular Genetics Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa (ITQB/UNL), Oeiras, Portugal.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Amorim
authors.forename: Carlos
authors.initials: C
authors.lastname: Vasconcelos
authors.forename: Duarte C
authors.initials: DC
authors.lastname: Oliveira
authors.forename: Ana
authors.initials: A
authors.lastname: Azevedo
authors.forename: Elsa
authors.initials: E
authors.lastname: Calado
authors.forename: Nuno A
authors.initials: NA
authors.lastname: Faria
authors.forename: Marta
authors.initials: M
authors.lastname: Pereira
authors.forename: Ana P
authors.initials: AP
authors.lastname: Castro
authors.forename: Alice
authors.initials: A
authors.lastname: Moreira
authors.forename: Ernestina
authors.initials: E
authors.lastname: Aires
authors.forename: José M
authors.initials: JM
authors.lastname: Cabeda
authors.forename: Maria H
authors.initials: MH
authors.lastname: Ramos
authors.forename: José M
authors.initials: JM
authors.lastname: Amorim
authors.forename: Hermínia
authors.initials: H
authors.lastname: de Lencastre
mesh_terms: D000328:Adult; D000368:Aged; D002353:Carrier State; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods*; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology*; D009726:Nurses; D010361:Patients; D011174:Portugal / Q000453:epidemiology; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*