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NHSN Annual Update:
Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections

Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007

Antimicrobial-resistant pathogens that cause healthcare-associated infections (HAIs) pose an ongoing and increasing challenge to hospitals, both in the clinical treatment of patients and in the prevention of the cross-transmission of these problematic pathogens.  Describing the magnitude of the problem with respect to these antimicrobial-resistant pathogens is challenging, because the levels of antimicrobial resistance vary for different types of healthcare facilities and for different geographic areas, and some resistance phenotypes are difficult for laboratories to detect. However, the findings from such attempts may help the infection control and public health communities target problems and utilize resources more efficiently.

In the News

Featured in The Times
"Ireland 'losing war' on superbug" February 15, 2009
Challenges of Implementing National Guidelines for the Control and Prevention of Methicillin‐Resistant Staphylococcus aureus Colonization or Infection in Acute Care Hospitals in the Republic of Ireland
Fidelma Fitzpatrick, MD; Fiona Roche, PhD; Robert Cunney, MB; Hilary Humphreys, MD; Strategy for the Control of Antimicrobial Resistance in Ireland Infection Control Subcommittee
The research, published in Infection Control and Hospital Epidemiology, found one third of hospitals did not have a written policy on antibiotic use, and only 35% had an antibiotic stewardship programme.

November 2006

Volume 27, Number 11
Infect Control Hosp Epidemiol 2006;27:1213–1218
0899-823X/2006/2711-0012$15.00
DOI: 10.1086/507920
Original Article

Community‐Acquired Infection With Healthcare‐Associated Methicillin‐Resistant Staphylococcus aureus: The Role of Home Nursing Care

François‐Xavier Lescure, MD, MPH;

Gwenaelle Locher, MD;

Mathieu Eveillard, PharmD, MPH;

Maurice Biendo, MD, MPH;

Stéphanie Van Agt, PharmD;

Guillaume Le Loup, MD, MPH;

Youcef Douadi, MD;

Olivier Ganry, MD, PhD;

François Vandenesch, MD, PhD;

François Eb, MD, PhD;

Jean‐Luc Schmit, MD, PhD;

Jerome Etienne, MD, PhD

From the Departments of Tropical and Infectious Diseases (F.‐X.L., G.L.L., Y.D., J.‐L.S.), Bacteriology (G.L., M.E., M.B., S.V.A., F.E.), and Epidemiology (O.G.), Hospital and University Centre, Amiens, and INSERM E0230, IFR62, Centre National de Référence des Staphylocoques, Faculté de Médecine Laennec, Lyon (F.V., J.E.), France. (Present affiliation: Service de maladies infectieuses et tropicales, Hôpital Tenon, Paris, France [F.‐X.L.].)

Objective.To better understand the role of indirect transmission in community‐acquired infection with methicillin‐resistant Staphylococcus aureus (MRSA).

Design.Prospective case‐control study.

Setting.A French teaching hospital.

Patients.A total of 198 case patients and 198 control patients with MRSA or methicillin‐susceptible S. aureus infection diagnosed between April 2002 and July 2003.

Results.Multivariate analysis showed a highly significant independent link between MRSA infection at admission and prior receipt of home nursing care (odds ratio [OR], 3.7; ). Other independent risk factors were prior hospitalization (OR, 3.8; ), transfer from another institution (OR, 2.3; ), and age older than 65 years (OR, 1.6; ). Prior home nursing care showed a frequency dose‐response relationship. Eleven MRSA‐infected patients had had home nursing procedures but no hospital stay in the previous 3 years. These patients’ MRSA strains were related to the prevalent MRSA clone currently spreading in French hospitals.

Conclusion.Home nursing care appears to be an independent risk factor for MRSA acquisition in the community. The reservoir probably consists of MRSA carriers discharged from the hospital. Community nurses seem to be a potential vector.

Received November 20, 2005; accepted February 23, 2006; electronically published October 20, 2006.

Address reprint requests to François‐Xavier Lescure, MD, MPH, Service de maladies infectieuses et tropicales, Hôpital Tenon, Assistance publique des hôpitaux de Paris (ap‐hp), 4 rue de la Chine, 75970 Paris cedex 20, France ().

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