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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.

August 2007

Volume 28, Number 8
Infect Control Hosp Epidemiol 2007;28:966–969
© 2007 by The Society for Healthcare Epidemiology of America. All rights reserved.
0899-823X/2007/2808-0012$15.00
DOI: 10.1086/518965
Original Article

Prevalence of Nasal Colonization Among Patients With Community‐Associated Methicillin‐Resistant Staphylococcus aureus Infection and Their Household Contacts

Uzma Zafar, MD;

Leonard B. Johnson, MD;

Michel Hanna, MD;

Kathleen Riederer, BS, MT;

Mamta Sharma, MD;

Mohamad G. Fakih, MD;

Muthayipalayam C. Thirumoorthi, MD;

Rand Farjo, MD;

Riad Khatib, MD

From the Department of Internal Medicine, St. John Hospital and Medical Center (U.Z., L.B.J., M.H., K.R., M.S., M.G.F., R.F., R.K.), and the Department of Internal Medicine, Wayne State University School of Medicine (L.B.J., M.S., M.G.F., M.C.T., R.K.), Detroit, Michigan.

Objective.To evaluate the prevalence of colonization among patients with community‐associated methicillin‐resistant Staphylococcus aureus (CA‐MRSA) infection and their household contacts.

Design.Prospective, observational laboratory study of nasal colonization among patients and their household members from September 15, 2004, to February 20, 2006.

Setting.A 600‐bed, urban, academic medical center.

Patients.Fifty‐one patients who presented with CA‐MRSA infections and 49 household members had cultures of nasal swab specimens performed.

Results.Skin and soft‐tissue infections were seen in 50 patients (98%) and 2 household members. Twenty‐one (41%) of 51 patients and 10 (20%) of 49 household members were colonized with MRSA. An additional 5 patients (10%) and 12 household members (24%) were colonized with methicillin‐susceptible Staphylococcus aureus. Most MRSA isolates (95%; infective and colonizing) carried the staphylococcal cassette chromosome mec type IV complex, and 67% represented a single clone, identical to USA 300. Of the colonized household members, 5 had isolates related to the patients’ infective isolate.

Conclusions.The frequency of CA‐MRSA colonization among household members of patients with CA‐MRSA infections is higher than rates reported among the general population. Among colonized household members, only half of the MRSA strains were related to the patients’ infective isolate. Within the same household, multiple strains of CA‐MRSA may be present.

Received October 10, 2006; accepted January 25, 2007; electronically published June 19, 2007.

Address reprint requests to Leonard B. Johnson, MD, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI 48236 ().

Cited by

Timothy F. Landers, RN, PhD; Randall E. Harris, MD, PhD; Thomas E. Wittum, PhD; Kurt B. Stevenson, MD, MPH. (2009) Colonization with Staphylococcus aureus and Methicillin‐Resistant S. aureus among a Sample of Homeless Individuals, Ohio •. Infection Control and Hospital Epidemiology 30:8, 801-803
Online publication date: 1-Aug-2009.
Citation-Full Text-PDF Version (175 kB)
Aaron E. Chen, Joseph B. Cantey, Karen C. Carroll, Tracy Ross, Sharon Speser, George K. Siberry. (2009) DISCORDANCE BETWEEN STAPHYLOCOCCUS AUREUS NASAL COLONIZATION AND SKIN INFECTIONS IN CHILDREN. The Pediatric Infectious Disease Journal 28:3, 244-246
Online publication date: 1-Apr-2009.
CrossRef
Richard P. Wenzel, MD, MSc; Gonzalo Bearman, MD, MPH; Michael B. Edmond, MD, MPH, MPA. (2008) Screening for MRSA: A Flawed Hospital Infection Control Intervention •. Infection Control and Hospital Epidemiology 29:11, 1012-1018
Online publication date: 1-Nov-2008.
Abstract-Full Text-PDF Version (198 kB)
Edina Avdic, Sara E Cosgrove. (2008) Management and control strategies for community-associated methicillin-resistant Staphylococcus aureus. Expert Opinion on Pharmacotherapy 9:9, 1463-1479
Online publication date: 1-Jul-2008.
CrossRef
Jason E. Farley. (2008) Epidemiology, clinical manifestations, and treatment options for skin and soft tissue infection caused by community-acquired methicillin-resistant Staphylococcus aureus. Journal of the American Academy of Nurse Practitioners 20:2, 85-92
Online publication date: 1-Mar-2008.
CrossRef

  • Presented in part: 45th International Conference on Antimicrobial Agents and Chemotherapy; Washington, DC; December 16‐19, 2005 (Abstract L‐145).

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