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Infect Control Hosp Epidemiol. 2014 Nov;35(11):1373-82. doi: 10.1086/678414. Epub 2014 Sep 22.

Persistent environmental contamination with USA300 methicillin-resistant Staphylococcus aureus and other pathogenic strain types in households with S. aureus skin infections.

Author information

1
Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.

Abstract

OBJECTIVE:

To understand the genotypic spectrum of environmental contamination of Staphylococcus aureus in households and its persistence.

DESIGN:

Prospective longitudinal cohort investigation.

SETTING:

Index participants identified at 2 academic medical centers.

PARTICIPANTS:

Adults and children with S. aureus skin infections and their household contacts in Los Angeles and Chicago.

METHODS:

Household fomites were surveyed for contamination at baseline and 3 months. All isolates underwent genetic typing.

RESULTS:

We enrolled 346 households, 88% of which completed the 3-month follow-up visit. S. aureus environmental contamination was 49% at baseline and 51% at 3 months. Among households with a USA300 methicillin-resistant S. aureus (MRSA) body infection isolate, environmental contamination with an indistinguishable MRSA strain was 58% at baseline and 63% at 3 months. Baseline factors associated with environmental contamination by the index subject's infection isolate were body colonization by any household member with the index subject's infection isolate at baseline (odds ratio [OR], 10.93 [95% confidence interval (CI), 5.75-20.79]), higher housing density (OR, 1.47 [95% CI, 1.10-1.96]), and more frequent household fomite cleaning (OR, 1.62 [95% CI, 1.16-2.27]). Household environmental contamination with the index subject's infection strain at 3 months was associated with USA300 MRSA and a synergistic interaction between baseline environmental contamination and body colonization by any household member with the index subject's infection strain.

CONCLUSIONS:

We found that infecting S. aureus isolates frequently persisted environmentally in households 3 months after skin infection. Presence of pathogenic S. aureus strain type in the environment in a household may represent a persistent reservoir that places household members at risk of future infection.

PMID:
25333432
DOI:
10.1086/678414
[Indexed for MEDLINE]

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