PIIS0163445321003583.pdf (804.51 kB)
Undetected carriage explains apparent Staphylococcus aureus acquisition in a non-outbreak healthcare setting
journal contribution
posted on 2023-06-10, 00:29 authored by James R Price, Maho Yokoyama, Kevin Cole, Jonathan Sweetman, Laura Behar, Simon Stoneham, Daire Cantillon, Simon WaddellSimon Waddell, Jonathan Hyde, Ruhina Alam, Derrick Crook, John Paul, Martin LlewelynMartin LlewelynObjectives Previous studies have been unable to identify patient or staff reservoirs for the majority of the nosocomial S. aureus acquisitions which occur in the presence of good infection control practice. We set out to establish the extent to which undetected pre-existing carriage explains apparent nosocomial S. aureus acquisition. Methods Over two years elective cardiothoracic admissions were screened for S. aureus carriage before and during hospital admission. Routine screening (nose/groin/wound sampling), was supplemented by sampling additional body sites (axilla/throat/rectum) and culture-based methods optimised to detect fastidious phenotypes (small colony variants, cell wall deficient variants) and molecular identification by PCR. Results 35% of participants (53/151) were S. aureus carriers according to routine pre-healthcare screening; increasing to 42% (63/151) when additional body sites and enhanced cultures were employed. 71% (5/7) of apparent acquisitions were explained by pre-existing carriage using augmented measures. Enhanced culture identified a minority of colonised individuals (3/151 including 1 MRSA carrier) who were undetected by routine and additional screening cultures. 4/14 (29%) participants who became culture-negative during admission had S. aureus genomic material detected at discharge.` Conclusions Conventional sampling under-estimates carriage of S. aureus and this explains the majority of apparent S. aureus acquisitions among elective cardiothoracic patients.
History
Publication status
- Published
File Version
- Published version
Journal
Journal of InfectionISSN
0163-4453Publisher
ElsevierExternal DOI
Issue
3Volume
83Page range
332-338Event location
EnglandDepartment affiliated with
- Global Health and Infection Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2021-07-30First Open Access (FOA) Date
2021-09-01First Compliant Deposit (FCD) Date
2021-07-29Usage metrics
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