Detecting Environmental Contamination of MRSA in Ambulances: A Novel and Efficient Sampling Methodology

Background: Methicillin-resistant Staphylococcus aureus (MRSA) can be found in emergency medical services (EMS) ambulances. This poses an occupational risk and patient safety hazard. Screening for environmental contamination is often not performed due to limited resources and logistical challenges. This study’s objective was to compare traditional screening of individual surfaces versus “pooled sampling” to efficiently identify contamination. Methods: A cross-sectional study, conducted among 145 Ohio EMS ambulances from 84 agencies, tested a novel pooled sampling methodology to detect MRSA contaminated ambulances. For ambulances screened using pooled sampling, 3 samples were collected within each ambulance. Pool One included cabinets, doorways, and ceiling bar. Pool Two included cot, seats, and backboard. Pool Three included steering wheel, kits, and clipboard. For ambulances screened with the traditional detection technique, each of the 9 aforementioned surfaces were sampled individually. Descriptive statistics and unadjusted and adjusted odds ratios (OR) were calculated to compare the 2 methods. Results: Forty-seven of 145 ambulances (32.4%) had at least 1 of the 9 locations contaminated with MRSA. When comparing the 2 screening methodologies, no significant difference was observed regarding the overall detection of MRSA contaminated ambulances (24/60 [40%] versus 23/85 [27.6%], P value: 0.1000). This indicates that pooled sampling appears as an efficient method for identification of MRSA contaminated ambulances. Conclusion: One-third of Ohio ambulances had MRSA contamination in this study. Therefore, an efficient methodology to identify contaminated ambulances with hazardous pathogens is incredibly valuable. Pooling can help save resources and simplify sampling logistics, all which could positively impact infection control practices in emergency medical services

Retrospective analysis of bovine leptospirosis diagnostic tests performered at the research and diagnosis unit of leptospirosis of Zulia university, 1998-2001

En el presente estudio se analizaron los resultados de sueros de bovinos procesados en la Unidad de Investigación y Diagnóstico de Leptospirosis de la Universidad del Zulia durante el período 1998-2001. De un total de 819 muestras provenientes de la región occidental de Venezuela, procesadas mediante la Técnica de Microaglutinación (MAT), se observó que 38% animales fueron seropositivos a uno o más serovares. Los serovares icterohaemorrhagiae (49%), hardjo (45%) y hebdomadis (44%) fueron los más frecuentes, sin evidenciar diferencias estadísticamente significativas entre si. En cuanto a la vacunación, se observó un 56% de seropositividad en animales no vacunados y 26% en animales vacunados. En relación a la edad, se obtuvo un 46% de seropositividad en animales mayores de 48 meses de edad, 35% en animales entre 12 y 48 meses de edad y 100% en bovinos menores de 12 meses de edad. De 270 animales con registros clínicos completos, 99% reportaron abortos como signo clínico más relevante, de los cuales el 49% fueron realmente positivos a leptospirosis. Se concluye que L. icterohaemorrhagiae y L. hardjo, fueron los serovares que circularon mayormente en el ganado bovino en la región occidental de Venezuela desde 1998 hasta 2001, siendo asociados en varias oportunidades a problemas abortivos. También se observó que los animales no vacunados presentaron una mayor seropositividad que los vacunados. Este estudio permitirá establecer una línea base para comparar las seroprevalencias actuales y futuras de la leptospirosis bovina en esta región, aportando información epidemiológica importante que permita el mejoramiento de medidas de prevención y control en contra de esta [email protected][email protected] from bovine serum samples processed at the Unit of Investigation and Diagnose of Leptospirosis of Zulia University, during the period 1998-2001 were analyzed in the present study. From a total of 819 samples submitted across the Western region in Venezuela, 38% were positive to one or more serovars by the Microagglutination Test (MAT). The most frequent serovars observed were icterohaemorrhagiae (49%), hardjo (45%) and hebdomadis (44%), however, no statistical significant differences were found between them. In regards to vaccination, 56% of the non-vaccinated animals and 26% of the vaccinated were seropositive. The age distribution showed that 46% of the animals older than 48 months, 35% of the animals between 12 and 48 months-old, and 100% of the animals younger than 12 months-old were positive to leptospira. From 270 animals with complete clinical records, 99% reported abortion as the main clinical sign, and 49% of them were indeed positives to leptospirosis. In conclusion, L. icterohaemorrhagiae and L. hardjo were the most common serovars circulating in the cattle population in the Western region in Venezuela between 1998 and 2001, in which several cases were associated with reproductive problems. It was also observed that non-vaccinated animals presented a higher seropositivity than animals that were vaccinated. This study will allow the establishment of a baseline to compare present and future studies on Bovine Leptospirosis in this region, providing important epidemiological information to be used in improving preventive and control measures against this disease

High prevalence of multidrug-resistant community-acquired methicillin-resistant staphylococcus aureus at the largest veterinary teaching hospital in Costa Rica

Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen associated with severe infections in companion animals present in the community, and it is diagnosed in animals admitted to veterinary hospitals. However, reports that describe the circulation of MRSA in animal populations and veterinary settings in Latin America are scarce. Therefore, the objective of this study was to determine the prevalence and investigate the molecular epidemiology of MRSA in the environment of the largest veterinary teaching hospital in Costa Rica. Preselected contact surfaces were sampled twice within a 6-week period. Antimicrobial resistance, SCCmec type, Panton-Valentine leukocidin screening, USA type, and clonality were assessed in all recovered isolates. Overall, MRSA was isolated from 26.5% (27/102) of the surfaces sampled, with doors, desks, and examination tables most frequently contaminated. Molecular analysis demonstrated a variety of surfaces from different sections of the hospital contaminated by three highly related clones/pulsotypes. All, but one of the isolates were characterized as multidrug-resistant SCCmec type IV-USA700, a strain sporadically described in other countries and often classified as community acquired. The detection and frequency of this unique strain in this veterinary setting suggest Costa Rica has a distinctive MRSA ecology when compared with other countries/regions. The high level of environmental contamination highlights the necessity to establish and enforce standard cleaning and disinfection protocols to minimize further spread of this pathogen and reduce the risk of nosocomial and/or occupational transmission of MRSA.El Staphylococcus aureus resistente a la meticilina (MRSA siglas en ingles) es un patógeno asociado a infecciones graves en animales de compañía animales de compañía presentes en la comunidad, y se diagnostica en animales ingresados en hospitales veterinarios. Sin embargo, los informes que describan la circulación de MRSA en poblaciones animales y entornos veterinarios en América Latina son escasos. Por lo tanto, el objetivo de este estudio fue determinar la prevalencia e investigar la epidemiología molecular del MRSA en el entorno del mayor hospital universitario veterinario de Costa Rica. Las superficies de contacto preseleccionadas se tomaron muestras dos veces en un período de 6 semanas. Se analizó la resistencia a los antimicrobianos, el tipo de SCCmec, la leucocidina Panton-Valentine y clonalidad en todos los aislados recuperados. En general, el MRSA se aisló de 26,5% (27/102) de las superficies muestreadas, siendo las puertas, los escritorios y las mesas de examen las más frecuentemente contaminadas. El análisis molecular demostró una variedad de superficies de diferentes secciones del hospital contaminadas por tres clones/pulsos altamente relacionados. Todos los aislados, excepto uno, se caracterizaron como SCCmec tipo IV-USA700, una cepa descrita esporádicamente en otros países y a menudo clasificada como adquirida en la comunidad. La detección y la frecuencia de esta cepa única en este entorno veterinario sugieren que Costa Rica tiene una ecología distintiva de MRSA en comparación con otros países. ecología del MRSA en comparación con otros países/regiones. El alto nivel de contaminación ambiental La alta contaminación ambiental subraya la necesidad de establecer y aplicar protocolos de limpieza y desinfección estándar para minimizar la minimizar la propagación de este patógeno y reducir el riesgo de transmisión nosocomial y/o laboral del MRSA.Escuela de Medicina Veterinari

Molecular epidemiology of environmental MRSA at an equine teaching hospital: introduction, circulation and maintenance

International audienceThe role that environmental contamination might play as a reservoir and a possible source of Methicillin-resistant Staphylococcus aureus (MRSA) for patients and personnel at equine veterinary hospitals remains undefined, as the environment has only been monitored during outbreaks or for short periods. Therefore, the objectives of this study were to determine the monthly presence, distribution, and characteristics of environmental MRSA at an equine hospital, and to establish patterns of contamination over time using molecular epidemiological analyses. For this purpose, a yearlong active MRSA surveillance was performed targeting the environment and incoming patients. Antimicrobial susceptibility testing, SCCmec typing, PFGE typing, and dendrographic analysis were used to characterize and analyze these isolates. Overall, 8.6% of the surfaces and 5.8% of the horses sampled were positive for MRSA. The most common contaminated surfaces were: computers, feed-water buckets, and surgery tables-mats. Ninety percent of the isolates carried SCCmec type IV, and 62.0% were classified as USA500. Molecular analysis showed that new pulsotypes were constantly introduced into the hospital throughout the year. However, maintenance of strains in the environment was also observed when unique clones were detected for 2 consecutive months on the same surfaces. Additionally, pulsotypes were circulating throughout several areas and different contact surfaces of the hospital. Based on these results, it is evident that MRSA is constantly introduced and frequently found in the equine hospital environment, and that some contact surfaces could act as “hot-spots”. These contaminated surfaces should be actively targeted for strict cleaning and disinfection as well as regular monitoring