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Cited by 30Antimicrobial Resistance in StaphylococcusInfection Control in HealthcareAntibiotic Use and Resistance

The DOI matches its Crossref record; 40 of the 40 references it cites were found in a registry or an index.

Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals

Open access
Shuping, Liliwe L., Kuonza, Lazarus, Musekiwa, Alfred, Iyaloo, Samantha, Perovic, Olga·2017·PLOS ONE
DOI 10.1371/journal.pone.0188216PMC PMC5690649
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Abstract

INTRODUCTION: Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. METHODS: We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA. RESULTS: Of the 9971 patients with positive blood cultures, 7.7% (772) had S. aureus bacteraemia (SAB). The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%- 34.3%). HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%- 31.7%). Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7-34.4), age ≤1 month (aOR 8.7; 95% CI 3.0-24.6), residency at a long-term care facility (aOR 5.2; 95% CI, 1.5-17.4), antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8-9.1), hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3-5.6) and mechanical ventilation (aOR 2.2; 95% CI 1.07-4.6), were independent risk factors for HA-MRSA infection. CONCLUSION: The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients.

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Fig 1 The number of SAB cases at five hospitals in Gauteng and Western Cape during 2014. AST, antimicrobial susceptibility testing results; SAB, S. aureus bacteraemia; CA, community-associated; HA, hospital-associated; MSSA, methicillin sensitive S. aureus; MRSA, methicillin-resistant S. aureus.
Fig 1 The number of SAB cases at five hospitals in Gauteng and Western Cape during 2014. AST, antimicrobial susceptibility testing results; SAB, S. aureus bacteraemia; CA, community-associated; HA, hospital-associated; MSSA, methicillin sensitive S. aureus; MRSA, methicillin-resistant S. aureus.CC BY · PubMed Central

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Research works printed but not linked: 1

  1. M Mendelson, 2015, The South African antimicrobial resistance strategy framework, Monitoring, surveillance and National Plans, 54

Cited by

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Metadata

Authors
Shuping, L. L., Kuonza, L., Musekiwa, A., Iyaloo, S., & Perovic, O.
Affiliations
National Health Laboratory Service (ZA)
Corresponding author
Perovic, Olga
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2017-11-16
Volume
12
Issue
11
Pages
e0188216
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0188216
PMC
PMC5690649
OpenAlex
W2768406667
Cited by
30
References
40
Citations by year
2026: 2 · 2025: 5 · 2024: 2 · 2023: 6 · 2022: 5 · 2021: 2 · 2020: 4 · 2019: 1 · 2018: 3
FWCI
1.68
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • UpSpace Institutional Repository (University of Pretoria) (submittedVersion, cc-by)
Funders
  • U.S. Department of Health and Human Services
  • National Health Laboratory Service
  • Centers for Disease Control and Prevention
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
Keywords
risk factors, Staphylococcus aureus bacteremia, bloodstream infection, burns, neonates, long-term care facilities, mechanical ventilation, length of hospital stay, antibiotic use, antimicrobial stewardship, infection control, MRSA prevalence, intensive care unit, burn ward
MeSH terms
Adolescent, Adult, Aged, Child, Child, Preschool, Cross Infection, Cross-Sectional Studies, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Risk Factors, South Africa, Staphylococcal Infections, Prevalence, Methicillin-Resistant Staphylococcus aureus, Young Adult

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