High rates of meticillin-resistant Staphylococcus aureus among asylum seekers and refugees admitted to Helsinki University Hospital, 2010 to 2017

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http://hdl.handle.net/10138/265528

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Aro , T & Kantele , A 2018 , ' High rates of meticillin-resistant Staphylococcus aureus among asylum seekers and refugees admitted to Helsinki University Hospital, 2010 to 2017 ' , Eurosurveillance , vol. 23 , no. 45 , 1700797 , pp. 21-34 . https://doi.org/10.2807/1560-7917.ES.2018.23.45.1700797

Title: High rates of meticillin-resistant Staphylococcus aureus among asylum seekers and refugees admitted to Helsinki University Hospital, 2010 to 2017
Author: Aro, Tuomas; Kantele, Anu
Contributor: University of Helsinki, Clinicum
University of Helsinki, Department of Medicine
Date: 2018-11-08
Language: eng
Number of pages: 14
Belongs to series: Eurosurveillance
ISSN: 1560-7917
URI: http://hdl.handle.net/10138/265528
Abstract: Introduction: Antimicrobial resistance is increasing rapidly in countries with low hygiene levels and poorly controlled antimicrobial use. The spread of resistant bacteria poses a threat to healthcare worldwide. Refugees and migrants from high-prevalence countries may add to a rise in multidrug-resistant (MDR) bacteria in low-prevalence countries. However, respective data are scarce. Methods: We retrospectively collected microbiological and clinical data from asylum seekers and refugees treated at Helsinki University Hospital between January 2010 and August 2017. Results: Of 447 asylum seekers and refugees (Iraq: 46.5%; Afghanistan: 10.3%; Syria: 9.6%, Somalia: 6.9%); 45.0% were colonised by MDR bacteria: 32.9% had extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE), 21.3% meticillin-resistant Staphylococcus aureus (MRSA), 0.7% carbap-enemase-producing Enterobacteriaceae (CPE), 0.4% multiresistant Pseudomonas aeruginosa (MRPA), 0.4% multiresistant Acinetobacter baumannii (MRAB); no vancomycin-resistant Enterococcus (VRE) were found. Two or more MDR bacteria strains were recorded for 12.5% of patients. Multivariable analysis revealed geographical region and prior surgery outside Nordic countries as risk factors of MRSA colonisation. Young age (<6 years old), short time from arrival to first sample, and prior hospitalisation outside Nordic countries were risk factors of ESBL-PE colonisation. Conclusion: We found MDR bacterial colonisation to be common among asylum seekers and refugees arriving from current conflict zones. In particular we found a high prevalence of MRSA. Refugees and migrants should, therefore, be included among risk populations requiring MDR screening and infection control measures at hospitals.
Subject: LACTAMASE-PRODUCING ENTEROBACTERIACEAE
ESBL-PRODUCING ENTEROBACTERIACEAE
CARBAPENEMASE-PRODUCING ENTEROBACTERIACEAE
ESCHERICHIA-COLI
RISK-FACTORS
MULTIRESISTANT ENTEROBACTERIACEAE
INTERNATIONAL TRAVEL
RETURNING TRAVELERS
MULTICENTER COHORT
COLONIZATION
3121 Internal medicine
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