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    
Abstract/OtherAbstract:
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.
Authors:
Adebola O Ajao; Anthony D Harris; Mary-Claire Roghmann; J Kristie Johnson; Min Zhan; Jessina C McGregor; Jon P Furuno
Related Documents :
17355409 - Appraising and comparing pressure ulcer guidelines.
12510469 - Risk factors associated with pressure ulcer development at a major western australian t...
8053599 - Production pressure in the work environment. california anesthesiologists' attitudes an...
9006479 - Can the nhs cope in future?
3646269 - The prevalence of pressure sores within an area health authority.
15071079 - Old age, malnutrition, and pressure sores: an ill-fated alliance.
6204149 - Does increasing potassium intake lower blood pressure in essential hypertension?
6694279 - Insurance premium reductions. a motivating factor in long-term hypertensive treatment.
1141099 - Lung mechanics in hypervolemic pulmonary edema.
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    
Affiliation:
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:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Clostridium Infections / 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:
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


Previous Document:  Deriving measures of intensive care unit antimicrobial use from computerized pharmacy data: methods,...
Next Document:  Molecular epidemiology and risk factors for colonization by vancomycin-resistant enterococcus in pat...