Factors associated with persistent colonisation with methicillin-resistant Staphylococcus aureus

CDC PREVENTION EPICENTERS PROGRAM

Research output: Contribution to journalArticle

Abstract

We conducted a prospective cohort study between 1 January 2010 and 31 December 2012 at five adult and paediatric academic medical centres to identify factors associated with persistent methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Adults and children presenting to ambulatory settings with a MRSA skin and soft tissue infection (i.e. index cases), along with household members, performed self-sampling for MRSA colonisation every 2 weeks for 6 months. Clearance of colonisation was defined as two consecutive negative sampling periods. Subjects without clearance by the end of the study were considered persistently colonised and compared with those who cleared colonisation. Of 243 index cases, 48 (19·8%) had persistent colonisation and 110 (45·3%) cleared colonisation without recurrence. Persistent colonisation was associated with white race (odds ratio (OR), 4·90; 95% confidence interval (CI), 1·38-17·40), prior MRSA infection (OR 3·59; 95% CI 1·05-12·35), colonisation of multiple sites (OR 32·7; 95% CI 6·7-159·3). Conversely, subjects with persistent colonisation were less likely to have been treated with clindamycin (OR 0·28; 95% CI 0·08-0·99). Colonisation at multiple sites is a risk factor for persistent colonisation and may require more targeted decolonisation efforts. The specific effect of clindamycin on MRSA colonisation needs to be elucidated.

Original languageEnglish (US)
Pages (from-to)1409-1417
Number of pages9
JournalEpidemiology and Infection
Volume145
Issue number7
DOIs
StatePublished - May 1 2017

Fingerprint

Methicillin-Resistant Staphylococcus aureus
Odds Ratio
Confidence Intervals
Clindamycin
Soft Tissue Infections
Cohort Studies
Prospective Studies
Pediatrics
Recurrence
Skin
Infection

Keywords

  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • MRSA colonisation
  • MRSA skin and soft tissue infections
  • persistent MRSA colonisation

ASJC Scopus subject areas

  • Epidemiology
  • Infectious Diseases

Cite this

Factors associated with persistent colonisation with methicillin-resistant Staphylococcus aureus. / CDC PREVENTION EPICENTERS PROGRAM.

In: Epidemiology and Infection, Vol. 145, No. 7, 01.05.2017, p. 1409-1417.

Research output: Contribution to journalArticle

CDC PREVENTION EPICENTERS PROGRAM. / Factors associated with persistent colonisation with methicillin-resistant Staphylococcus aureus. In: Epidemiology and Infection. 2017 ; Vol. 145, No. 7. pp. 1409-1417.
@article{a65d94dfe01f45169e5fe8af5a50cf51,
title = "Factors associated with persistent colonisation with methicillin-resistant Staphylococcus aureus",
abstract = "We conducted a prospective cohort study between 1 January 2010 and 31 December 2012 at five adult and paediatric academic medical centres to identify factors associated with persistent methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Adults and children presenting to ambulatory settings with a MRSA skin and soft tissue infection (i.e. index cases), along with household members, performed self-sampling for MRSA colonisation every 2 weeks for 6 months. Clearance of colonisation was defined as two consecutive negative sampling periods. Subjects without clearance by the end of the study were considered persistently colonised and compared with those who cleared colonisation. Of 243 index cases, 48 (19·8{\%}) had persistent colonisation and 110 (45·3{\%}) cleared colonisation without recurrence. Persistent colonisation was associated with white race (odds ratio (OR), 4·90; 95{\%} confidence interval (CI), 1·38-17·40), prior MRSA infection (OR 3·59; 95{\%} CI 1·05-12·35), colonisation of multiple sites (OR 32·7; 95{\%} CI 6·7-159·3). Conversely, subjects with persistent colonisation were less likely to have been treated with clindamycin (OR 0·28; 95{\%} CI 0·08-0·99). Colonisation at multiple sites is a risk factor for persistent colonisation and may require more targeted decolonisation efforts. The specific effect of clindamycin on MRSA colonisation needs to be elucidated.",
keywords = "Methicillin-resistant Staphylococcus aureus (MRSA), MRSA colonisation, MRSA skin and soft tissue infections, persistent MRSA colonisation",
author = "{CDC PREVENTION EPICENTERS PROGRAM} and Cluzet, {V. C.} and Gerber, {J. S.} and I. Nachamkin and Coffin, {S. E.} and Meghan Davis and Julian, {K. G.} and Zaoutis, {T. E.} and Metlay, {J. P.} and Linkin, {D. R.} and P. Tolomeo and Wise, {J. A.} and Bilker, {W. B.} and B. Hu and E. Lautenbach",
year = "2017",
month = "5",
day = "1",
doi = "10.1017/S0950268817000012",
language = "English (US)",
volume = "145",
pages = "1409--1417",
journal = "Epidemiology and Infection",
issn = "0950-2688",
publisher = "Cambridge University Press",
number = "7",

}

TY - JOUR

T1 - Factors associated with persistent colonisation with methicillin-resistant Staphylococcus aureus

AU - CDC PREVENTION EPICENTERS PROGRAM

AU - Cluzet, V. C.

AU - Gerber, J. S.

AU - Nachamkin, I.

AU - Coffin, S. E.

AU - Davis, Meghan

AU - Julian, K. G.

AU - Zaoutis, T. E.

AU - Metlay, J. P.

AU - Linkin, D. R.

AU - Tolomeo, P.

AU - Wise, J. A.

AU - Bilker, W. B.

AU - Hu, B.

AU - Lautenbach, E.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - We conducted a prospective cohort study between 1 January 2010 and 31 December 2012 at five adult and paediatric academic medical centres to identify factors associated with persistent methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Adults and children presenting to ambulatory settings with a MRSA skin and soft tissue infection (i.e. index cases), along with household members, performed self-sampling for MRSA colonisation every 2 weeks for 6 months. Clearance of colonisation was defined as two consecutive negative sampling periods. Subjects without clearance by the end of the study were considered persistently colonised and compared with those who cleared colonisation. Of 243 index cases, 48 (19·8%) had persistent colonisation and 110 (45·3%) cleared colonisation without recurrence. Persistent colonisation was associated with white race (odds ratio (OR), 4·90; 95% confidence interval (CI), 1·38-17·40), prior MRSA infection (OR 3·59; 95% CI 1·05-12·35), colonisation of multiple sites (OR 32·7; 95% CI 6·7-159·3). Conversely, subjects with persistent colonisation were less likely to have been treated with clindamycin (OR 0·28; 95% CI 0·08-0·99). Colonisation at multiple sites is a risk factor for persistent colonisation and may require more targeted decolonisation efforts. The specific effect of clindamycin on MRSA colonisation needs to be elucidated.

AB - We conducted a prospective cohort study between 1 January 2010 and 31 December 2012 at five adult and paediatric academic medical centres to identify factors associated with persistent methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Adults and children presenting to ambulatory settings with a MRSA skin and soft tissue infection (i.e. index cases), along with household members, performed self-sampling for MRSA colonisation every 2 weeks for 6 months. Clearance of colonisation was defined as two consecutive negative sampling periods. Subjects without clearance by the end of the study were considered persistently colonised and compared with those who cleared colonisation. Of 243 index cases, 48 (19·8%) had persistent colonisation and 110 (45·3%) cleared colonisation without recurrence. Persistent colonisation was associated with white race (odds ratio (OR), 4·90; 95% confidence interval (CI), 1·38-17·40), prior MRSA infection (OR 3·59; 95% CI 1·05-12·35), colonisation of multiple sites (OR 32·7; 95% CI 6·7-159·3). Conversely, subjects with persistent colonisation were less likely to have been treated with clindamycin (OR 0·28; 95% CI 0·08-0·99). Colonisation at multiple sites is a risk factor for persistent colonisation and may require more targeted decolonisation efforts. The specific effect of clindamycin on MRSA colonisation needs to be elucidated.

KW - Methicillin-resistant Staphylococcus aureus (MRSA)

KW - MRSA colonisation

KW - MRSA skin and soft tissue infections

KW - persistent MRSA colonisation

UR - http://www.scopus.com/inward/record.url?scp=85013374208&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85013374208&partnerID=8YFLogxK

U2 - 10.1017/S0950268817000012

DO - 10.1017/S0950268817000012

M3 - Article

C2 - 28219463

AN - SCOPUS:85013374208

VL - 145

SP - 1409

EP - 1417

JO - Epidemiology and Infection

JF - Epidemiology and Infection

SN - 0950-2688

IS - 7

ER -