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Post-Transplant Events

Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak

Bone Marrow Transplantation volume 39, pages 623–629 (2007)Cite this article

Abstract

Meticillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen, with an increased incidence in the UK since 1993, causing serious morbidity and mortality in immunosuppressed patients. We analysed the frequency and outcome of MRSA infection in a single-centre transplant population over a 5-year period. The total number of patients infected was 41/776 (5%). The frequency in autologous, sibling and unrelated donor transplants was 3, 6 and 9%, respectively. Prior to 2004, the incidence was <4%/year; however, an outbreak in the day unit resulted in 22 patients becoming newly infected. Over 90% of infections were clinically relevant, half (49%) being bacteraemia. Three patterns were seen: known MRSA positive at any time before transplant (n=15), MRSA first detected during the neutropenia phase (n=5) and MRSA only post discharge (n=21). MRSA was implicated in a number of deaths, at all time points, in those infected. An intensive eradication policy resulted in new infections dropping to <2%. In conclusion, MRSA is likely to remain endemic in our unit, but robust early screening protocols and aggressive eradication strategies have effectively limited the spread of and morbidity due to this pathogen.

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Authors and Affiliations

  1. Department of Clinical Haematology, Nottingham University Hospitals, Nottingham, UK

    B E Shaw, J L Byrne & N H Russell

  2. Department of Microbiology and Infection Control, Nottingham University Hospitals, Nottingham, UK

    T Boswell & C Yates

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  1. B E Shaw
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  2. T Boswell
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  3. J L Byrne
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  4. C Yates
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  5. N H Russell
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Correspondence to B E Shaw.

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Shaw, B., Boswell, T., Byrne, J. et al. Clinical impact of MRSA in a stem cell transplant unit: analysis before, during and after an MRSA outbreak. Bone Marrow Transplant 39, 623–629 (2007). https://doi.org/10.1038/sj.bmt.1705654

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