Successful control of methicillin-resistant Staphylococcus aureus in a spinal cord injury center: a 10-year prospective study including molecular typing

Study design: Prospective cohort study with medical record review. Objective: To evaluate the clinical utility of an infection control program in a patient cohort at high risk for methicillin-resistant Staphylococcus aureus (MRSA) infection and to identify risk factors interfering with successful de...

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Bibliographic Details
Published in:Spinal cord 2008-06, Vol.46 (6), p.438-444
Main Authors: Kappel, C, Widmer, A, Geng, V, von Arx, P, Frei, R, Koch, H-G, Knecht, H
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anatomy
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Canada - epidemiology
Cerebrospinal fluid. Meninges. Spinal cord
Cohort Studies
Colonization
Control programs
Cross Infection - epidemiology
Cross Infection - prevention & control
Drug resistance
Epidemics
Female
Gel electrophoresis
Hospitals
Hospitals, University - statistics & numerical data
Human Physiology
Humans
Infection
Infection Control
Injuries of the nervous system and the skull. Diseases due to physical agents
Internet
Male
medical records
Medical sciences
Methicillin Resistance
Middle Aged
Molecular Epidemiology
Nervous system (semeiology, syndromes)
Neurochemistry
Neurology
Neuropsychology
Neurosciences
original-article
Paralysis
Retrospective Studies
Risk Factors
Spinal Cord Injuries - drug therapy
Spinal Cord Injuries - epidemiology
Spinal cord injury
Staphylococcal Infections - drug therapy
Staphylococcal Infections - epidemiology
Staphylococcus aureus
Traumas. Diseases due to physical agents
Typing
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Summary:Study design: Prospective cohort study with medical record review. Objective: To evaluate the clinical utility of an infection control program in a patient cohort at high risk for methicillin-resistant Staphylococcus aureus (MRSA) infection and to identify risk factors interfering with successful decolonization of MRSA. Setting: All spinal cord injured (SCI) patients hospitalized at the Swiss Paraplegic Center (SPC) Nottwil from April 1991 to April 2001. Methods: Patients whose medical records indicated laboratory-confirmed MRSA colonization or infection were included. Incidence of MRSA colonization or infection was classified as community acquired, nosocomial or transferred based on standardized criteria. Risk factors for community-acquired MRSA colonization in SCI patients were determined. MRSA subtyping and identification of nosocomial spread was performed through pulse-field gel electrophoresis (PFGE). Results: Of 5992 admissions, 100 episodes of MRSA (colonization 22 cases, infection 78 cases) were identified among 76 patients. Overall incidence (1991–2001) per 1000 patient days was 0.26 cases on admission compared to 0.08 at discharge ( P
ISSN:1362-4393
1476-5624
DOI:10.1038/sj.sc.3102135