Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit in India.
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a global pathogen and an important but seldom investigated cause of morbidity and mortality in lower and middle-income countries where it can place a major burden on limited resources. Quantifying nosocomial transmission in resource-...
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th-mahidol.8012023-03-31T11:33:05Z Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit in India. Christopher, Solomon Verghis, Rejina Mariam Antonisamy, Belavendra Sowmyanarayanan, Thuppal Varadachari Brahmadathan, Kootallur Narayanan Kang, Gagandeep Cooper, Ben Symons Christopher, Solomon Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unit. India Methicillin-resistant Staphylococcus aureus Open Access article BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a global pathogen and an important but seldom investigated cause of morbidity and mortality in lower and middle-income countries where it can place a major burden on limited resources. Quantifying nosocomial transmission in resource-poor settings is difficult because molecular typing methods are prohibitively expensive. Mechanistic statistical models can overcome this problem with minimal cost. We analyse the transmission dynamics of MRSA in a hospital in south India using one such approach and provide conservative estimates of the organism's economic burden. METHODS AND FINDINGS: Fifty months of MRSA infection data were collected retrospectively from a Medical Intensive Care Unit (MICU) in a tertiary hospital in Vellore, south India. Data were analysed using a previously described structured hidden Markov model. Seventy-two patients developed MRSA infections and, of these, 49 (68%) died in the MICU. We estimated that 4.2% (95%CI 1.0, 19.0) of patients were MRSA-positive when admitted, that there were 0.39 MRSA infections per colonized patient month (0.06, 0.73), and that the ward-level reproduction number for MRSA was 0.42 (0.08, 2.04). Anti-MRSA antibiotic treatment costs alone averaged $124/patient, over three times the monthly income of more than 40% of the Indian population. CONCLUSIONS: Our analysis of routine data provides the first estimate of the nosocomial transmission potential of MRSA in India. The high levels of transmission estimated underline the need for cost-effective interventions to reduce MRSA transmission in hospital settings in low and middle income countries. 2015-06-26T02:44:59Z 2016-10-10T09:05:23Z 2015-06-26T02:44:59Z 2016-10-10T09:05:23Z 2011 2015-06-22 2011 Article Christopher S, Verghis RM, Antonisamy B, Sowmyanarayanan TV, Brahmadathan KN, Kang G. et al. Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit in India. PLoS One. 2011;6(7):e20604. 10.1371/journal.pone.0020604 1932-6203 (electronic) https://repository.li.mahidol.ac.th/handle/123456789/801 eng PLoS ONE application/pdf |
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India Methicillin-resistant Staphylococcus aureus Open Access article Christopher, Solomon Verghis, Rejina Mariam Antonisamy, Belavendra Sowmyanarayanan, Thuppal Varadachari Brahmadathan, Kootallur Narayanan Kang, Gagandeep Cooper, Ben Symons Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit in India. |
description |
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a global
pathogen and an important but seldom investigated cause of morbidity and
mortality in lower and middle-income countries where it can place a major burden
on limited resources. Quantifying nosocomial transmission in resource-poor
settings is difficult because molecular typing methods are prohibitively
expensive. Mechanistic statistical models can overcome this problem with minimal
cost. We analyse the transmission dynamics of MRSA in a hospital in south India
using one such approach and provide conservative estimates of the organism's
economic burden.
METHODS AND FINDINGS: Fifty months of MRSA infection data were collected
retrospectively from a Medical Intensive Care Unit (MICU) in a tertiary hospital
in Vellore, south India. Data were analysed using a previously described
structured hidden Markov model. Seventy-two patients developed MRSA infections
and, of these, 49 (68%) died in the MICU. We estimated that 4.2% (95%CI 1.0,
19.0) of patients were MRSA-positive when admitted, that there were 0.39 MRSA
infections per colonized patient month (0.06, 0.73), and that the ward-level
reproduction number for MRSA was 0.42 (0.08, 2.04). Anti-MRSA antibiotic
treatment costs alone averaged $124/patient, over three times the monthly income
of more than 40% of the Indian population.
CONCLUSIONS: Our analysis of routine data provides the first estimate of the
nosocomial transmission potential of MRSA in India. The high levels of
transmission estimated underline the need for cost-effective interventions to
reduce MRSA transmission in hospital settings in low and middle income countries. |
author2 |
Christopher, Solomon |
author_facet |
Christopher, Solomon Christopher, Solomon Verghis, Rejina Mariam Antonisamy, Belavendra Sowmyanarayanan, Thuppal Varadachari Brahmadathan, Kootallur Narayanan Kang, Gagandeep Cooper, Ben Symons |
format |
Article |
author |
Christopher, Solomon Verghis, Rejina Mariam Antonisamy, Belavendra Sowmyanarayanan, Thuppal Varadachari Brahmadathan, Kootallur Narayanan Kang, Gagandeep Cooper, Ben Symons |
author_sort |
Christopher, Solomon |
title |
Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit in India. |
title_short |
Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit in India. |
title_full |
Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit in India. |
title_fullStr |
Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit in India. |
title_full_unstemmed |
Transmission dynamics of methicillin-resistant Staphylococcus aureus in a medical intensive care unit in India. |
title_sort |
transmission dynamics of methicillin-resistant staphylococcus aureus in a medical intensive care unit in india. |
publishDate |
2015 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/801 |
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1764209917840850944 |