A prospective study to examine the epidemiology of methicillin-resistant Staphylococcus aureus and Clostridium difficile contamination in the general environment of three community hospitals in southern Ontario, Canada

BMC Infectious Diseases

Research Article

J Scott Weese¹  Meredith C Faires²  David L Pearl²  Olaf Berke³  Richard J Reid-Smith⁴  Karen Straus⁵  William A Ciccotelli⁶  Giovanna Zinken⁷ 

[1] Department of Pathobiology, University of Guelph, Guelph, ON, Canada;Department of Population Medicine, University of Guelph, Guelph, ON, Canada;Department of Population Medicine, University of Guelph, Guelph, ON, Canada;Department of Mathematics and Statistics, University of Guelph, Guelph, ON, Canada;Department of Population Medicine, University of Guelph, Guelph, ON, Canada;Department of Pathobiology, University of Guelph, Guelph, ON, Canada;Infection Prevention and Control, Grand River Hospital, Kitchener, ON, Canada;Infection Prevention and Control, Grand River Hospital, Kitchener, ON, Canada;Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada;Infection Prevention and Control, St. Mary’s General Hospital, Kitchener, ON, Canada;

关键词: Staphylococcus aureus;    Clostridium difficile;    Hospital;    General environment;    Risk factors;    Livestock-associated MRSA strain;    Spa;    Ribotyping;   

DOI  :  10.1186/1471-2334-12-290

 received in 2012-06-28, accepted in 2012-11-01,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe hospital environment has been suggested as playing an important role in the transmission of hospital-associated (HA) pathogens. However, studies investigating the contamination of the hospital environment with methicillin-resistant Staphylococcus aureus (MRSA) or Clostridium difficile have generally focused on point prevalence studies of only a single pathogen. Research evaluating the roles of these two pathogens, concurrently, in the general hospital environment has not been conducted. The objectives of this study were to determine the prevalence and identify risk factors associated with MRSA and C. difficile contamination in the general environment of three community hospitals, prospectively.MethodsSampling of environmental surfaces distributed over the medicine and surgical wards at each hospital was conducted once a week for four consecutive weeks. Sterile electrostatic cloths were used for environmental sampling and information regarding the surface sampled was recorded. For MRSA, air sampling was also conducted. Enrichment culture was performed and spa typing was performed for all MRSA isolates. For C. difficile, isolates were characterized by ribotyping and investigated for the presence of toxin genes by PCR. Using logistic regression, the following risk factors were examined for MRSA or C. difficile contamination: type of surface sampled, surface material, surface location, and the presence/absence of the other HA pathogen under investigation.ResultsOverall, 11.8% (n=612) and 2.4% (n=552) of surfaces were positive for MRSA and C. difficile, respectively. Based on molecular typing, five different MRSA strains and eight different C. difficile ribotypes, including ribotypes 027 (15.4%) and 078 (7.7%), were identified in the hospital environment. Results from the logistic regression model indicate that compared to computer keyboards, the following surfaces had increased odds of being contaminated with MRSA: chair backs, hand rails, isolation carts, and sofas.ConclusionsMRSA and C. difficile were identified from a variety of surfaces in the general hospital environment.Several surfaces had an increased risk of being contaminated with MRSA but further studies regarding contact rates, type of surface material, and the populations using these surfaces are warranted.

【 授权许可】

CC BY   
© Faires et al.; licensee BioMed Central Ltd. 2012