PLoS ONE
Volume 13, Issue 5, 2018

High prevalence of MRSA and multi-resistant gram-negative bacteria in refugees admitted to the hospital—But no hint of transmission (Article) (Open Access)

Kossow A.* , Stühmer B. , Schaumburg F. , Becker K. , Glatz B. , Möllers M. , Kampmeier S. , Mellmann A.
  • a Institute of Hygiene, University Hospital Münster, Münster, Germany
  • b International Patient Management, University Hospital Münster, Münster, Germany
  • c Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
  • d Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
  • e Clinic for Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
  • f Clinic for Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
  • g Institute of Hygiene, University Hospital Münster, Münster, Germany
  • h Institute of Hygiene, University Hospital Münster, Münster, Germany

Abstract

With high numbers of refugees arriving in Europe uncertainty exists as to whether multidrug-resistant organisms are imported into the healthcare system. In our study, we identified 383 refugee-inpatients admitted to the University Hospital Münster, Germany between September 2015 and September 2016. For this patient cohort screening for Methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Gram-negative bacteria (MDR-GNB) and Vancomycin-resistant enterococci (VRE) was recommended in our institution. Until May 2016 pre-emptive isolation was applied to all refugee-inpatients until the exclusion of these multidrug-resistant organisms. MRSA were found in 34 refugee-patients (9.8%), MDR-GNB in 25 refugee-patients (12.9%) and VRE in none of the refugee patients. We did not find any strains carrying carbapenemases. Whole genome sequencing (WGS) data demonstrated that the respective isolates were genetically heterogeneous and revealed no transmission of refugee-patient isolates to other patients. We therefore omitted pre-emptive isolation as an infection control measure for this group of patients. Furthermore, molecular typing did not show evidence for nosocomial transmission from refugee-patients to other patients. Standard hygiene measures successfully prevented the transmission of refugee-patient isolates to other patients and as a result introduction into the healthcare system. This underlines that any multidrug-resistant organisms present within this cohort are not of any extraordinary concern for health systems. © 2018 Kossow et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Author Keywords

[No Keywords available]

Index Keywords

genetics hospital admission Germany refugee mass screening physiology university hospital human Refugees middle aged statistics and numerical data controlled study Aged nonhuman hygiene Young Adult Humans Hospitals, University Adolescent Infant, Newborn male preschool child Aged, 80 and over Infant very elderly Child, Preschool newborn female prevalence isolation and purification Gram negative bacterium Article disease transmission adult Methicillin-Resistant Staphylococcus aureus Gram-Negative Bacteria multidrug resistant Gram negative bacteria contact isolation vancomycin resistant Enterococcus cohort analysis health care system bacterial strain whole genome sequencing methicillin resistant Staphylococcus aureus Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85047894917&doi=10.1371%2fjournal.pone.0198103&partnerID=40&md5=ae684647842c152c4760d048f98ce114
DOI: 10.1371/journal.pone.0198103
ISSN: 19326203
Original Language: English