| Systematic review of measurement and adjustment for colonization pressure in studies of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and clostridium difficile acquisition. | |
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MedLine Citation:
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PMID: 21515979 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Colonization pressure is an important infection control metric. The aim of this study was to describe the definition and measurement of and adjustment for colonization pressure in nosocomial-acquisition risk factor studies of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile. METHODS: We performed a computerized search of studies of nosocomial MRSA, VRE, and C. difficile acquisition published before July 1, 2009, through MEDLINE. Studies were included if a study outcome was MRSA, VRE, or C. difficile acquisition; the authors identified risk factors associated with MRSA, VRE, or C. difficile acquisition; and the study measured colonization pressure. RESULTS: The initial MEDLINE search yielded 505 articles. Sixty-six of these were identified as studies of nosocomial MRSA, VRE, or C. difficile acquisition; of these, 18 (27%) measured colonization pressure and were included in the final review. The definition of colonization pressure varied considerably between studies: the proportion of MRSA- or VRE-positive patients (5 studies), the proportion of MRSA- or VRE-positive patient-days (6 studies), or the total or mean number of MRSA-, VRE-, or C. difficile-positive patients or patient-days (7 studies) in the unit over periods of varying length. In 10 of 13 studies, colonization pressure was independently associated with MRSA, VRE, or C. difficile acquisition. CONCLUSION: There is a need for a simple and consistent method to quantify colonization pressure in both research and routine clinical care to accurately assess the effect of colonization pressure on cross-transmission of antibiotic-resistant bacteria. |
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Authors:
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Adebola O Ajao; Anthony D Harris; Mary-Claire Roghmann; J Kristie Johnson; Min Zhan; Jessina C McGregor; Jon P Furuno |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Review |
Journal Detail:
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Title: Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America Volume: 32 ISSN: 1559-6834 ISO Abbreviation: Infect Control Hosp Epidemiol Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-25 Completed Date: 2011-08-04 Revised Date: 2012-10-09 |
Medline Journal Info:
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Nlm Unique ID: 8804099 Medline TA: Infect Control Hosp Epidemiol Country: United States |
Other Details:
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Languages: eng Pagination: 481-9 Citation Subset: IM; N |
Affiliation:
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Department of Epidemiology and Public Health, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF Room 360 Baltimore, Maryland 21201, USA. aajao@epi.umaryland.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Clostridium Infections
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transmission Clostridium difficile* Colony Count, Microbial Cross Infection / epidemiology* Enterococcus* Gram-Positive Bacterial Infections / transmission* Humans Infection Control / methods Methicillin-Resistant Staphylococcus aureus* Risk Assessment Risk Factors Staphylococcal Infections / transmission Vancomycin Resistance* |
| Grant Support | |
ID/Acronym/Agency:
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1K01AI071015-03/AI/NIAID NIH HHS; 1K24AI079040/AI/NIAID NIH HHS; K01 AI071015/AI/NIAID NIH HHS; K24 AI079040/AI/NIAID NIH HHS; KL2RR024131/RR/NCRR NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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