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Contexte : dans le département des urgences des cliniques du Centre Hospitalier Chrétien (5 services), une procédure sur le dépistage du Staphylococcus aureus résistant à la méthicilline (MRSA) a été mise en place dans l’intention de détecter précocement les patients colonisés et/ou infectés avant leur hospitalisation, afin d’appliquer rapidement les précautions additionnelles et de réduire ainsi les transmissions croisées.
But : ce travail permet d’examiner l’adéquation entre la connaissance de la procédure de dépistage de MRSA par l’infirmier urgentiste, son application dans la pratique quotidienne et les résultats des frottis prélevés chez les patients à risque avant leur hospitalisation.
Méthodologie : La première partie du travail se penche sur un questionnaire relatif à la méthodologie de la procédure, rempli par les infirmiers urgentistes des cliniques Saint-Joseph à Liège, Espérance à Montegnée, Notre-Dame à Hermalle-sous-Argenteau, Notre-Dame à Waremme et Sainte-Elisabeth à Heusy. La deuxième partie du travail investigue 500 dossiers patients répartis équitablement entre les 5 cliniques afin d’étudier l’opérationnalisation du dépistage par approche quantitative.
Résultats : la première partie reflète le ressenti de l’infirmier face à la connaissance de la procédure par une approche quantitative. La seconde partie du travail permet de mettre en exergue, par l’analyse de régression logistique multinomiale, que les patients originaires d’une maison de repos ont plus de probabilité d’être dépistés aux urgences (p=0,005 avec OR : 3,52 et IC 95% : 1,65 – 7,50). De plus, les personnes présentant une alerte informatique signalant un portage antérieur de MRSA ont un risque accru d’avoir un frottis MRSA positif (p=0,03 avec OR : 7,15 et IC 95% : 1,64 – 31,19).
Conclusion : Cette étude démontre que les moyens mis en œuvre pour surveiller le portage de MRSA au niveau institutionnel sont efficaces (5,14% des patients dépistés étaient positifs soit 11 sur 214) mais qu’il est important de suivre l’évaluation des pratiques pour encourager le personnel à poursuivre leurs efforts dans l’application de la procédure (65,7%).

MRSA, dépistage, surveillance, soins infirmiers, services des urgences --- Sciences de la santé humaine > Immunologie & maladie infectieuse

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This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact

Methicillin resistant Staphylococcus aureus (MRSA) --- Methicillin susceptible S. aureus (MSSA) --- MRSA protracted outbreaks --- Whole-genome sequencing --- evolution --- Molecular Epidemiology --- antimicrobial resistance --- Point of Care Testing --- staphylococcal mobile genetic elements --- staphylococcal cassette chromosome mec (SCCmec)

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This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact

Science: general issues --- Medical microbiology & virology --- Microbiology (non-medical) --- mass spectometry --- MALDI-TOF --- susceptibility testing --- carbapenamase --- resistance detection --- MRSA - Methicillin-resistant Staphylococcus aureus

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This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact

Science: general issues --- Medical microbiology & virology --- Microbiology (non-medical) --- Methicillin resistant Staphylococcus aureus (MRSA) --- Methicillin susceptible S. aureus (MSSA) --- MRSA protracted outbreaks --- Whole-genome sequencing --- evolution --- Molecular Epidemiology --- antimicrobial resistance --- Point of Care Testing --- staphylococcal mobile genetic elements --- staphylococcal cassette chromosome mec (SCCmec)

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Although 30% of the healthy human population is colonized with various Staphylococcus species, some staphylococcal strains, referred to as opportunistic pathogens, can cause minor to life-threatening diseases. The pathogenicity of these bacteria depends on their virulence factors and the robustness of the regulatory networks expressing these virulence factors. Virulence factors of pathogenic Staphylococcus spp. consist of numerous toxins, enterotoxins (some of which act as superantigens), enzymes, and proteins (cytoplasmic, extracellular, and surface) that are regulated by two-component (TC) and quorum-sensing (QS) regulatory networks. To enter this niche, some other Staphylococcus species, such as Staphylococcus simulans, produce a potent endopeptidase called lysostaphin, which can inhibit the growth of pathogenic S. aureus. Some other Staphylococcus species produce autolysins and cationic peptides to win the intra- and inter-species competition. The outcome of this microbial invasion depends not only on pathogenic factors but also on the host’s internal and external defense mechanisms, including a healthy skin microbiome. A healthy skin microbiome population can prevent colonization by other major pathogens. As normal host microflora, these commensals establish a complex relationship with the host as well as the surrounding microbial communities. This Special Issue of Microorganisms is focused on studies and recent advancements in our understanding of staphylococcal virulence mechanisms that enable Staphylococcus spp. either to successfully establish themselves as a colonizer or to overcome the host’s defense system to cause infection along with our effort to make an anti-staphylococcal vaccine.

Research & information: general --- Biology, life sciences --- biofilm --- MRSA --- silver ion --- silver sulfadiazine --- wound infections --- Staphylococcus aureus --- methicillin resistance --- human infection --- CC130 --- biomaterials --- medical devices --- HL-60 cells --- PMNs --- endotracheal tube --- titanium --- implantable devices --- nosocomial diseases --- Staphylococcus lugdunensis --- sortase A --- surface proteins --- LPXTG --- small colony variants --- influenza virus --- super-infection --- pro-inflammatory response --- rural Ghana --- molecular epidemiology --- chronic wounds --- invasive disease --- surgery-associated infection --- sepsis --- SA4Ag vaccine --- conjugated polysaccharide --- ClfA --- MntC --- protection --- animal models --- phase variation --- Staphylococcus epidermidis --- microbiota --- multidrug resistance --- genome sequencing --- phylogenetic analyses --- arthroplasty surgery --- methicillin-resistant Staphylococcus aureus (MRSA) --- community-associated MRSA (CA-MRSA) --- CA-MRSA strain USA300 --- murine skin infection model --- dermatopathology --- dermonecrosis --- neutrophil --- host antibacterial response --- cytokine --- chemokine --- physiology --- metabolism --- carbon catabolite repression --- CcpA --- HPr --- colonization --- mouse --- JSNZ --- aurintricarboxylic acid --- ATA --- adhesion inhibitor --- mupirocin --- nose --- superantigen --- mastitis --- food intoxication --- regulation --- sec variants --- CM lipids --- daptomycin resistance --- resensitization --- n/a