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Methicillin-resistant Staphylococcus aureus: investigation of a hospital outbreak using a case-controlled study

Methicillin-resistant Staphylococcus aureus: investigation of a hospital outbreak using a case-controlled study
Methicillin-resistant Staphylococcus aureus: investigation of a hospital outbreak using a case-controlled study
A retrospective case-control study of 50 MRSA-positive patients was carried out during an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) at an acute general hospital in London. Controls were randomly selected from MRSA-negative patients admitted during the outbreak period. Risk factors investigated included length of admission prior to screening, number of ward changes, main diagnosis, extent of staff contact, pressure sores, surgical and other invasive procedures and antibiotic treatment. Outcome variables examined were rates of infection (versus colonization) with MRSA and mortality. Patients with MRSA were in hospital longer before microbiological specimens were taken and moved wards more often than controls. In a logistic regression analysis, length of stay in hospital, pressure sores, physiotherapy and surgical procedures were associated with a significantly increased risk of acquiring MRSA. Odds ratios (and 95% confidence intervals) for having acquired MRSA were: 8.3(1.02-71.43) if a patient had pressure sores; 3.7 (1.10-12.5) if they received physiotherapy; and 3.2 (1.82-10.0) if they underwent surgical procedures.
The rate of clinical infection amongst patients with this strain of MRSA was 26% and included life-threatening infections such as septicaemia, underlining the potential virulence of MRSA. Surgery and physiotherapy may have been markers of debility. Physiotherapy was probably a marker of increased rates of contact with all hospital staff, and high standards of hand hygiene should be promoted amongst all staff as the most important factor in controlling an outbreak of MRSA. Good bed management is essential for hospital infection control.
methicillin resistance, Staphylococcus aureus, case-control study, disease outbreaks, virulence
0195-6701
301-309
CROWCROFT, N.
889bde14-3c15-42f8-a027-4fe9997942b5
MAGUIRE, H.
0bf9d811-e3eb-4649-8783-8da179b58807
FLEMING, M.
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Peacock, J.L.
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THOMAS, J.
f1e19646-8c39-432e-a968-7ba4eccb864e
CROWCROFT, N.
889bde14-3c15-42f8-a027-4fe9997942b5
MAGUIRE, H.
0bf9d811-e3eb-4649-8783-8da179b58807
FLEMING, M.
6887958f-15d3-4c16-8db2-b0ace5408869
Peacock, J.L.
8362b3b1-458f-4152-936f-344ca1c7e0ba
THOMAS, J.
f1e19646-8c39-432e-a968-7ba4eccb864e

CROWCROFT, N., MAGUIRE, H., FLEMING, M., Peacock, J.L. and THOMAS, J. (1996) Methicillin-resistant Staphylococcus aureus: investigation of a hospital outbreak using a case-controlled study. Journal of Hospital Infection, 34 (4), 301-309.

Record type: Article

Abstract

A retrospective case-control study of 50 MRSA-positive patients was carried out during an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) at an acute general hospital in London. Controls were randomly selected from MRSA-negative patients admitted during the outbreak period. Risk factors investigated included length of admission prior to screening, number of ward changes, main diagnosis, extent of staff contact, pressure sores, surgical and other invasive procedures and antibiotic treatment. Outcome variables examined were rates of infection (versus colonization) with MRSA and mortality. Patients with MRSA were in hospital longer before microbiological specimens were taken and moved wards more often than controls. In a logistic regression analysis, length of stay in hospital, pressure sores, physiotherapy and surgical procedures were associated with a significantly increased risk of acquiring MRSA. Odds ratios (and 95% confidence intervals) for having acquired MRSA were: 8.3(1.02-71.43) if a patient had pressure sores; 3.7 (1.10-12.5) if they received physiotherapy; and 3.2 (1.82-10.0) if they underwent surgical procedures.
The rate of clinical infection amongst patients with this strain of MRSA was 26% and included life-threatening infections such as septicaemia, underlining the potential virulence of MRSA. Surgery and physiotherapy may have been markers of debility. Physiotherapy was probably a marker of increased rates of contact with all hospital staff, and high standards of hand hygiene should be promoted amongst all staff as the most important factor in controlling an outbreak of MRSA. Good bed management is essential for hospital infection control.

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More information

Published date: December 1996
Keywords: methicillin resistance, Staphylococcus aureus, case-control study, disease outbreaks, virulence

Identifiers

Local EPrints ID: 72835
URI: http://eprints.soton.ac.uk/id/eprint/72835
ISSN: 0195-6701
PURE UUID: 438ff969-a319-4950-a890-eb3f4f7084ff

Catalogue record

Date deposited: 23 Feb 2010
Last modified: 07 Jan 2022 23:42

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Contributors

Author: N. CROWCROFT
Author: H. MAGUIRE
Author: M. FLEMING
Author: J.L. Peacock
Author: J. THOMAS

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