Multidrug and mupirocin resistance in environmental methicillin-resistant Staphylococcus aureus (MRSA) isolates from homes of people diagnosed with community-onset MRSA infection

J. H. Shahbazian, P. D. Hahn, S. Ludwig, J. Ferguson, P. Baron, A. Christ, K. Spicer, P. Tolomeo, A. M. Torrie, W. B. Bilker, V. C. Cluzet, B. Hu, Kathleen Julian, I. Nachamkin, S. C. Rankin, D. O. Morris, E. Lautenbach, M. F. Davis

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Patients with community-onset (CO) methicillin-resistant Staphylococcus aureus (MRSA) infections contribute to MRSA contamination of the home environment and may be reexposed to MRSA strains from this reservoir. This study evaluates One Health risk factors, which focus on the relationship between humans, animals, and the environment, for the increased prevalence of multiple antimicrobial-resistant MRSA isolates in the home environment. During a trial of patients with CO-MRSA infection, MRSA was isolated from the household environment at the baseline and 3 months later, following randomization of patients and household members to mupirocin-based decolonization therapy or an education control group. Up to two environmental MRSA isolates collected at each visit were tested. MRSA isolates were identified in 68% (65/ 95) of homes at the baseline (n = 104 isolates) and 51% (33/65) of homes 3 months later (n = 56 isolates). The rates of multidrug resistance (MDR) were 61% among isolates collected at the baseline and 55% among isolates collected at the visit 3 months later. At the baseline, 100% (14/14) of MRSA isolates from rural homes were MDR. While antimicrobial use by humans or pets was associated with an increased risk for the isolation of MDR MRSA from the environment, clindamycin use was not associated with an increased risk for the isolation of MDR MRSA. Incident low-level mupirocin-resistant MRSA strains were isolated at 3 months from 2 (5%) of 39 homes that were randomized to mupirocin treatment but none of the control homes. Among patients recently treated for a CO-MRSA infection, MRSA and MDR MRSA were common contaminants in the home environment. This study contributes to evidence that occupant use of antimicrobial drugs, except for clindamycin, is associated with MDR MRSA in the home environmental reservoir. (This study has been registered at ClinicalTrials.gov under registration no. NCT00966446).

Original languageEnglish (US)
Article numbere01369-17
JournalApplied and environmental microbiology
Volume83
Issue number22
DOIs
StatePublished - Nov 1 2017

Fingerprint

Mupirocin
Multiple Drug Resistance
Methicillin-Resistant Staphylococcus aureus
Infection
infection
decolonization
multiple drug resistance
risk factor
health risk
drug
education
pollutant
animal
clindamycin
Clindamycin
methicillin-resistant Staphylococcus aureus
anti-infective agents
households
household

All Science Journal Classification (ASJC) codes

  • Biotechnology
  • Food Science
  • Applied Microbiology and Biotechnology
  • Ecology

Cite this

Shahbazian, J. H. ; Hahn, P. D. ; Ludwig, S. ; Ferguson, J. ; Baron, P. ; Christ, A. ; Spicer, K. ; Tolomeo, P. ; Torrie, A. M. ; Bilker, W. B. ; Cluzet, V. C. ; Hu, B. ; Julian, Kathleen ; Nachamkin, I. ; Rankin, S. C. ; Morris, D. O. ; Lautenbach, E. ; Davis, M. F. / Multidrug and mupirocin resistance in environmental methicillin-resistant Staphylococcus aureus (MRSA) isolates from homes of people diagnosed with community-onset MRSA infection. In: Applied and environmental microbiology. 2017 ; Vol. 83, No. 22.
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title = "Multidrug and mupirocin resistance in environmental methicillin-resistant Staphylococcus aureus (MRSA) isolates from homes of people diagnosed with community-onset MRSA infection",
abstract = "Patients with community-onset (CO) methicillin-resistant Staphylococcus aureus (MRSA) infections contribute to MRSA contamination of the home environment and may be reexposed to MRSA strains from this reservoir. This study evaluates One Health risk factors, which focus on the relationship between humans, animals, and the environment, for the increased prevalence of multiple antimicrobial-resistant MRSA isolates in the home environment. During a trial of patients with CO-MRSA infection, MRSA was isolated from the household environment at the baseline and 3 months later, following randomization of patients and household members to mupirocin-based decolonization therapy or an education control group. Up to two environmental MRSA isolates collected at each visit were tested. MRSA isolates were identified in 68{\%} (65/ 95) of homes at the baseline (n = 104 isolates) and 51{\%} (33/65) of homes 3 months later (n = 56 isolates). The rates of multidrug resistance (MDR) were 61{\%} among isolates collected at the baseline and 55{\%} among isolates collected at the visit 3 months later. At the baseline, 100{\%} (14/14) of MRSA isolates from rural homes were MDR. While antimicrobial use by humans or pets was associated with an increased risk for the isolation of MDR MRSA from the environment, clindamycin use was not associated with an increased risk for the isolation of MDR MRSA. Incident low-level mupirocin-resistant MRSA strains were isolated at 3 months from 2 (5{\%}) of 39 homes that were randomized to mupirocin treatment but none of the control homes. Among patients recently treated for a CO-MRSA infection, MRSA and MDR MRSA were common contaminants in the home environment. This study contributes to evidence that occupant use of antimicrobial drugs, except for clindamycin, is associated with MDR MRSA in the home environmental reservoir. (This study has been registered at ClinicalTrials.gov under registration no. NCT00966446).",
author = "Shahbazian, {J. H.} and Hahn, {P. D.} and S. Ludwig and J. Ferguson and P. Baron and A. Christ and K. Spicer and P. Tolomeo and Torrie, {A. M.} and Bilker, {W. B.} and Cluzet, {V. C.} and B. Hu and Kathleen Julian and I. Nachamkin and Rankin, {S. C.} and Morris, {D. O.} and E. Lautenbach and Davis, {M. F.}",
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Shahbazian, JH, Hahn, PD, Ludwig, S, Ferguson, J, Baron, P, Christ, A, Spicer, K, Tolomeo, P, Torrie, AM, Bilker, WB, Cluzet, VC, Hu, B, Julian, K, Nachamkin, I, Rankin, SC, Morris, DO, Lautenbach, E & Davis, MF 2017, 'Multidrug and mupirocin resistance in environmental methicillin-resistant Staphylococcus aureus (MRSA) isolates from homes of people diagnosed with community-onset MRSA infection', Applied and environmental microbiology, vol. 83, no. 22, e01369-17. https://doi.org/10.1128/AEM.01369-17

Multidrug and mupirocin resistance in environmental methicillin-resistant Staphylococcus aureus (MRSA) isolates from homes of people diagnosed with community-onset MRSA infection. / Shahbazian, J. H.; Hahn, P. D.; Ludwig, S.; Ferguson, J.; Baron, P.; Christ, A.; Spicer, K.; Tolomeo, P.; Torrie, A. M.; Bilker, W. B.; Cluzet, V. C.; Hu, B.; Julian, Kathleen; Nachamkin, I.; Rankin, S. C.; Morris, D. O.; Lautenbach, E.; Davis, M. F.

In: Applied and environmental microbiology, Vol. 83, No. 22, e01369-17, 01.11.2017.

Research output: Contribution to journalArticle

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T1 - Multidrug and mupirocin resistance in environmental methicillin-resistant Staphylococcus aureus (MRSA) isolates from homes of people diagnosed with community-onset MRSA infection

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AU - Hahn, P. D.

AU - Ludwig, S.

AU - Ferguson, J.

AU - Baron, P.

AU - Christ, A.

AU - Spicer, K.

AU - Tolomeo, P.

AU - Torrie, A. M.

AU - Bilker, W. B.

AU - Cluzet, V. C.

AU - Hu, B.

AU - Julian, Kathleen

AU - Nachamkin, I.

AU - Rankin, S. C.

AU - Morris, D. O.

AU - Lautenbach, E.

AU - Davis, M. F.

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N2 - Patients with community-onset (CO) methicillin-resistant Staphylococcus aureus (MRSA) infections contribute to MRSA contamination of the home environment and may be reexposed to MRSA strains from this reservoir. This study evaluates One Health risk factors, which focus on the relationship between humans, animals, and the environment, for the increased prevalence of multiple antimicrobial-resistant MRSA isolates in the home environment. During a trial of patients with CO-MRSA infection, MRSA was isolated from the household environment at the baseline and 3 months later, following randomization of patients and household members to mupirocin-based decolonization therapy or an education control group. Up to two environmental MRSA isolates collected at each visit were tested. MRSA isolates were identified in 68% (65/ 95) of homes at the baseline (n = 104 isolates) and 51% (33/65) of homes 3 months later (n = 56 isolates). The rates of multidrug resistance (MDR) were 61% among isolates collected at the baseline and 55% among isolates collected at the visit 3 months later. At the baseline, 100% (14/14) of MRSA isolates from rural homes were MDR. While antimicrobial use by humans or pets was associated with an increased risk for the isolation of MDR MRSA from the environment, clindamycin use was not associated with an increased risk for the isolation of MDR MRSA. Incident low-level mupirocin-resistant MRSA strains were isolated at 3 months from 2 (5%) of 39 homes that were randomized to mupirocin treatment but none of the control homes. Among patients recently treated for a CO-MRSA infection, MRSA and MDR MRSA were common contaminants in the home environment. This study contributes to evidence that occupant use of antimicrobial drugs, except for clindamycin, is associated with MDR MRSA in the home environmental reservoir. (This study has been registered at ClinicalTrials.gov under registration no. NCT00966446).

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