Methicillin-resistant Staphylococcus aureus nasal carriage among patients receiving hemodialysis in Taiwan: prevalence rate, molecular characterization and de-colonization
Open Access
- 1 November 2012
- journal article
- Published by Springer Science and Business Media LLC in BMC Infectious Diseases
- Vol. 12 (1), 284
- https://doi.org/10.1186/1471-2334-12-284
Abstract
Staphylococcus aureus, particularly methicillin resistant (MRSA), is a common pathogen among patients receiving hemodialysis. To evaluate nasal carriage, molecular characterization and effectiveness of decolonization of MRSA among patients receiving hemodialysis in Taiwan, we conducted this study. From January to June 2011, two nasal samplings with a 3-month interval were obtained from patients undergoing hemodialysis in a medical center (CGMH), and in a local hospital (YMH) and sent for detection of MRSA. For MRSA carriers, decolonization procedures were administered. All patients in CGMH were observed if MRSA infections occurred during the study period. A total of 529 nasal specimens (265 from CGMH and 264 from YMH) were collected from 296 patients (161 from CGMH and 135 from YMH). 233 patients participated in both surveys. Average one-time point MRSA carriage rate was 3.8%, and the rate was up to 6.9% for those with two-time point surveys. No additional significant factor for MRSA carriage was identified. Seventy percent of the 20 colonizing MRSA isolates, though categorized as healthcare-associated strains epidemiologically, shared common molecular characteristics of the local community-associated strains. Only one of the 20 MRSA-colonized patients failed decolonization and had persistent colonization, while without any intervention, 17 (61%) of 28 patients with methicillin-sensitive S. aureus colonization in the first survey had persistent colonization of a genetically indistinguishable strain. Within the study period, two patients (1.24%) in CGMH, one with MRSA colonization (9.1%), developed MRSA infection. A substantial proportion of patients receiving hemodialysis in Taiwan had MRSA colonization, mostly genetically community strains. Decolonization procedures may effectively eliminate MRSA colonization and might reduce subsequent MRSA infection in these patients.Keywords
This publication has 30 references indexed in Scilit:
- Nasal Swab Screening for Methicillin-Resistant Staphylococcus aureus—How Well Does It Perform? A Cross-Sectional StudyInfection Control & Hospital Epidemiology, 2012
- Staphylococcal decolonisation: an effective strategy for prevention of infection?The Lancet Infectious Diseases, 2011
- Methicillin-Resistant Staphylococcus aureus Nasal Colonization among Adult Patients Visiting Emergency Department in a Medical Center in TaiwanPLOS ONE, 2011
- Prevalence, persistence, and microbiology of Staphylococcus aureus nasal carriage among hemodialysis outpatients at a major New York HospitalDiagnostic Microbiology and Infectious Disease, 2011
- Nasal Carriage of Methicillin-resistant Staphylococcus aureus Is Associated with Higher All-Cause Mortality in Hemodialysis PatientsClinical Journal of the American Society of Nephrology, 2011
- Prevalence of and Risk Factors for Colonization by Methicillin-Resistant Staphylococcus aureus among Adults in Community Settings in TaiwanJournal of Clinical Microbiology, 2009
- Methicillin-resistant Staphylococcus aureus carriage, infection and transmission in dialysis patients, healthcare workers and their family membersNephrology Dialysis Transplantation, 2007
- Combination of Multiplex PCRs for Staphylococcal Cassette Chromosome mec Type Assignment: Rapid Identification System for mec , ccr , and MajorDifferences in Junkyard RegionsAntimicrobial Agents and Chemotherapy, 2007
- Community-associated Methicillin-resistantStaphylococcus aureusin Hospital Nursery and Maternity UnitsEmerging Infectious Diseases, 2005
- Nasal Carriage as a Source ofStaphylococcus aureusBacteremiaNew England Journal of Medicine, 2001