Meticillin-resistant Staphylococcus aureus and meticillin-susceptible Staphylococcus aureus screening in a cohort of haemodialysis patients: carriage, demographics and outcomes. Issue 1 (May 2015)

• Record Type: Journal Article
• Authors: Price, A.; Sarween, N.; Gupta, I.; Baharani, J.
• Is Part Of: Journal of hospital infection. Volume 90:Issue 1(2015)
• Page Start: 22
• Page End: 27
• Publication Date: 2015-05
• Subjects: Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2015.01.001
• Languages: English
• ISSNs: 0195-6701

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Background</title> <p id="abspara0010">Patients on haemodialysis are vulnerable to colonization with <italic>Staphylococcus aureus</italic> due to frequent hospital contact, indwelling devices, and impaired immunity. Additionally colonization is associated with increased risk of infection.</p> </sec> <sec> <title id="sectitle0020">Aim</title> <p id="abspara0015">To determine the prevalence of both meticillin-resistant <italic>S. aureus</italic> (MRSA) and meticillin-susceptible <italic>S. aureus</italic> (MSSA) carriage in our haemodialysis cohort and to identify any risk factors predisposing to carriage, recolonization, or persistent carriage following a decolonization programme.</p> </sec> <sec> <title id="sectitle0025">Methods</title> <p id="abspara0020">All haemodialysis patients screened for <italic>S. aureus</italic> carriage between June 2009 and May 2011 were retrospectively followed up for 18 months using hospital electronic records. Statistical analysis was performed using IBM SPSS version 19.</p> </sec> <sec> <title id="sectitle0030">Findings</title> <p id="abspara0025">Out of 578 patients screened, 288 patients (49%) had at least one positive swab (10% MRSA, 90% MSSA). Of these patients, 265 completed a course of decolonization therapy following which 36% successfully eradicated (eradicators) and 64% did not (non-eradicators). There was no statistically significant difference in patient demography, type of vascular access, 18-month patient mortality, or number of hospital admissions between the two groups. Those who failed to eradicate were more likely to have had an episode of <italic>S. aureus</italic> bacteraemia within the study period compared to those who successfully decolonized (<italic>P</italic> = 0.003).</p> </sec> <sec> <title id="sectitle0035">Conclusion</title> <p id="abspara0030">Half of our haemodialysis cohort was colonized with <italic>S. aureus</italic> at any one time over an 18-month period. Following decolonization, one-third of patients remained successfully eradicated for 18 months. Non-eradicators have an increased risk of bacteraemia, which is associated with poor mortality. We would recommend routine screening and aggressive attempts to decolonize.</p> </sec> </abstract>