Methicillin-Resistant staphylococcus aureus carriage in hemodialysis vicinity: Prevalence and decolonization approach

Abstract

Hemodialysis (HD) patients are at risk for developing serious infections. Methicillin- resistant Staphylococcus aureus (MRSA) is one of the most prevalent pathogens in healthcare facilities with a major threat to the medical community. We aimed to determine the prevalence of MRSA colonization among patients and medical staff members in a HD Unit and determine efficacy of mupirocin as a decolonizing agent. This cross-sectional study enrolled 250 patients and 35 health care providers of a HD unit. Nasal and hand swabs were collected to assess the prevalence of MRSA carriage. Those exhibiting MRSA phenotype were subjected to conventional Polymerase chain reaction (PCR) assay for detection of mecA gene. Colonized patients and medical personnel with MRSA were prescribed mupirocin ointment (2%) for decolonization. The screening approach identified 54/285 (18.9%) nasal MRSA carriers (41/250 of HD patients and 13/35 of the medical staff members). Concomitant extranasal MRSA colonization of the hands was observed in 10 (18.5%) of these 54 MRSA carriers. In relation to PCR results the sensitivity, specificity, and diagnostic accuracy of cefoxitin disk test were 98.2%, 75%, and 93.9% respectively and for MRSA Select II agar screening method, the sensitivity, specificity, and diagnostic accuracy were 92.6%, 66.7%, and 87.9% respectively. Decolonization approach using mupirocin ointment revealed an overall success rate up to 77.8% (42/54) and failure rate of 16.7% (9/54), while 5.6% (3/54) of decolonized carriers showed recolonization. There is still high prevalence of MRSA colonization in HD vicinity. Implementation of strict infection control measures is essential in dialysis units to avoid MRSA cross-transmission and invasive infections.

Phenotype-Genotype Characterization and Antibiotic-Resistance Correlations Among Colonizing and Infectious Methicillin-Resistant Staphylococcus aureus Recovered from Intensive Care Units

“…Clonal complex 8 (CC8) is known to be one of the most prevalent clones throughout the world and a significant proportion of health-care-associated infections is related to strains belonging to this clonal complex. 44,48 The methicillin resistance (mecA) gene, which encodes for the altered penicillin-binding protein (PBP2a) production, responsible for classical methicillin resistance, 49 was found in all isolates except for one colonizing isolate. This may be explained by the presence of alterations in the existing PBPs.…”

Evaluation of a micro/nanofluidic chip platform for diagnosis of central nervous system infections: a multi-center prospective study

“…87.76%; sensitivity, specificity, PPV and NPV were all higher than 80% 21,22 . Similar with the literature reports 23,24 , vancomycin-related genes (Van-A, and Van-B) are the most popular genes in Enterococcus; the concordance rate, specificity and NPV of vancomycin-related genes and phenotypes were higher than 80%, while the sensitivity rate and PPV were higher than 70%.…”

Prevalence of infections and antimicrobial use among hemodialysis outpatients: A prospective multicenter study

“…However, the large data on isolates among Chinese hemodialysis patients are scarce. Given the high attendant mortality and complications caused by Staphylococcal species, especially of high prevalence of MRSA colonization in hemodialysis vicinity, more efforts must be made to reduce the spread in the hemodialysis setting.…”

“…However, the large data on isolates among Chinese hemodialysis patients are scarce. Given the high attendant mortality and complications caused by Staphylococcal species,6 especially of high prevalence of MRSA colonization in hemodialysis vicinity,30 more efforts must be made to reduce the spread in the The usage of fistula among female group (79.9%) was lower than male group (85.3%); on the contrary, the usage of central line among female group (19.0%) was about two times higher than male group (10.4%). The other reason might partly be due to the difference in age.…”