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• W4375846839 abstract "Environmental contamination with meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) in skilled nursing facilities (SNFs) may contribute to patient acquisition. This study assessed diversity and association of MRSA and VRE isolates in an SNF wing, and developed a mathematical index to define the tendency of each strain to persist in rooms and spread horizontally.This was a longitudinal study of MRSA and VRE colonization and contamination among successive patient occupancies in a cluster of nine SNF private rooms over 8 months, characterized by microbiological testing and whole-genome isolate typing. The 'dispersion index' of a strain was defined as the number of rooms in which it was found (including if it was found in the patient), divided by the average number of times it was found consecutively in the same room.MRSA (10 strain types) and VRE (seven types) were recovered from the room or patient in 16.4% and 35.6% of the occupancies, respectively. MRSA showed moderate horizontal spread and several episodes of same-room persistence (three distinct strain types) (overall dispersion index 1.08). VRE showed a high tendency towards horizontal spread/new introductions (overall dispersion index 3.25) and only one confirmed episode of persistence.The emerging picture of high diversity among contaminating strains and high likelihood of room persistence despite terminal cleaning (MRSA) and horizontal spread between rooms (VRE) in this setting calls for improved cleaning practices, heightened contact precautions and, most of all, establishment of individually tailored facility screening programmes to enable informed choices based on local, measurable and actionable epidemiologic parameters." @default.
• W4375846839 created "2023-05-10" @default.
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• W4375846839 date "2023-08-01" @default.
• W4375846839 modified "2023-09-26" @default.
• W4375846839 title "Diversity and persistence of MRSA and VRE in skilled nursing facilities: environmental screening, whole-genome sequencing and development of a dispersion index" @default.
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• W4375846839 doi "https://doi.org/10.1016/j.jhin.2023.04.015" @default.
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