Healthcare Superbugs: The Re-Emergence of Hospital Pathogens

Healthcare Superbugs: The Re-Emergence of Hospital Pathogens

Virginia Geriatric Society Annual Conference

Gonzalo Bearman MD, MPH Associate Professor of Medicine, Epidemiology and Community Health Associate Hospital Epidemiologist Virginia Commonwealth University April 3rd, 2009

Staphylococcus aureus Facts

? Half of all S. aureus strains in U.S. healthcare facilities are resistant to methicillin

? Historically, methicillin-susceptible S. aureus (MSSA) strains were mostly acquired in the community, whereas methicillin?resistant strains (MRSA) were typically acquired in healthcare facilities

? There have been increasing reports of MRSA acquired in the community setting

Community Associated MRSA

? Definition:

? MRSA clinical isolate from a patient without established risk factors for MRSA infection

? Risk factors include:

? Within the last year:

? History of hospitalization, surgery, or residence in a long term care facility

? Presence of indwelling catheter or percutaneous device

? Prior history of MRSA infection or colonization

Adapted from Fridkin et al. New England Journal of Medicine, April 7, 2005

Community Acquired MRSA

? PVL positive Community acquired MRSA

? Panton-Valentine-Leukocidine (PVL) gene

? Cytotoxin produced by ................
................

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