Document Detail

Systematic review of measurement and adjustment for colonization pressure in studies of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and clostridium difficile acquisition.
MedLine Citation:
PMID:  21515979     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
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:
Created Date:  2011-04-25     Completed Date:  2011-08-04     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  8804099     Medline TA:  Infect Control Hosp Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  481-9     Citation Subset:  IM; N    
Department of Epidemiology and Public Health, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF Room 360 Baltimore, Maryland 21201, USA.
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MeSH Terms
Clostridium Infections / transmission
Clostridium difficile*
Colony Count, Microbial
Cross Infection / epidemiology*
Gram-Positive Bacterial Infections / transmission*
Infection Control / methods
Methicillin-Resistant Staphylococcus aureus*
Risk Assessment
Risk Factors
Staphylococcal Infections / transmission
Vancomycin Resistance*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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