S. aureus screening program helps identify hospital transmissions
Click Here to Manage Email Alerts
Key takeaways:
- A hospital implemented a screening program to help identify Staphylococcus aureus transmissions.
- Three-quarters of transmissions would have been missed without the surveillance cultures.
HOUSTON — A Staphylococcus aureus screening program paired with genomic sequencing and electronic health data improved a New York hospital’s ability to identify transmissions and patients at high risk, according to a study.
For more than a year, the hospital screened adults at admission and children weekly in the ICU and oncology unit, accounting for more than 6,500 surveillance isolates.
“S. aureus colonization of skin and mucous membranes precedes invasive infection, but the burden and impact of this cannot be assessed without surveillance for asymptomatic colonization,” Sarah Hochman, MD, a hospital epidemiologist and section chief of infectious diseases at NYU Langone Tisch Hospital, told Healio.
“Similarly, we are unable to measure in-hospital S. aureus transmission and the impact of infection prevention interventions without whole-genome sequencing analysis of surveillance and clinical S. aureus isolates to identify highly related S. aureus strains that are likely to reflect a recent transmission,” Hochman said.
According to Hochman, early pilot data showed that patients with S. aureus colonization had significantly higher rates of S. aureus invasive infection compared with patients who are not colonized with S. aureus, and asymptomatic patients could transmit to other patients, causing invasive S. aureus infections.
“This prompted us to expand our S. aureus screening and sequencing program,” she said.
For the study, which was presented at the Society for Healthcare Epidemiology of America Spring Conference, the hospital collected nasal swabs from adults at admission to medicine, transplant, oncology and ICUs at NYU Langone Health. They also collected weekly nares, axilla and groin swabs from children admitted to ICUs and oncology units.
The researchers performed whole-genome sequencing on all MRSA identified through screening and clinical cultures and all methicillin-susceptible S. aureus (MSSA) from screening and blood cultures. They used electronic health data to assess plausible hospital transmissions and evaluate S. aureus transmissions.
In total, they analyzed 8,567 S. aureus isolates, including 6,552 screening cultures, 1,008 blood cultures and 1,007 clinical cultures. Using these isolates in addition to the sequencing and electronic health data, they identified 424 plausible S. aureus hospital transmissions — 75% of which they believe would have been missed without the screening cultures.
The study also showed that MSSA colonization accounted for the majority of transmissions in children (62%), whereas MRSA colonization accounted for more than half of adult transmissions (56%). The highest frequency of transmissions was reported in EDs and neonatal intensive care units.
“An S. aureus screening program, coupled with genome sequencing and electronic health data, can identify patient groups, hospital locations and clonal complexes that are at high risk for S. aureus transmissions,” Hochman said.
Collapse
Hochman S, et al. Abstract 319. Presented at: Society for Healthcare Epidemiology of America Spring Conference; April 16-19; Houston.
Read more about
Click Here to Manage Email Alerts