Nasal Colonization and Molecular Characterization of Methicillin-Resistant Staphylococcus aureus among Hemodialysis Patients in 7 Korean Hospitals.
10.14192/kjnic.2013.18.2.51
- Author:
Jae Seok KIM
;
Sun Hwa LEE
;
Joseph JEONG
;
Kyoung Ho ROH
;
Hae Kyung LEE
;
Sook Jin JANG
;
Hye Soo LEE
;
Jeong Uk KIM
;
Sung Hee LEE
;
Joon Sup YEOM
;
Sang Oh LEE
;
Jeong Sil CHOI
;
So Yeon YOO
;
Jae Sim JEONG
;
Mi Na KIM
- Publication Type:Original Article
- Keywords:
Colonization;
Dialysis unit;
Hemodialysis;
Infection control;
MRSA;
Staphylococcus aureus
- MeSH:
Colon*;
Humans;
Infection Control;
Methicillin Resistance*;
Methicillin-Resistant Staphylococcus aureus*;
Mucous Membrane;
Multiplex Polymerase Chain Reaction;
Renal Dialysis*;
Skin;
Staphylococcus aureus
- From:Korean Journal of Nosocomial Infection Control
2013;18(2):51-56
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Staphylococcus aureus is a major bacteremia-causing pathogen in hemodialysis patients, frequently colonizing patient skin and mucosa. Active infection control is necessary to prevent methicillin-resistant S. aureus (MRSA) infection in hospitals; however, the spread of community-associated MRSA has recently become a concern for MRSA infection control. We evaluated the nasal colonization of MRSA among hemodialysis patients and the molecular characterization of the MRSA isolates. METHODS: Nasal swabs were obtained from 482 hemodialysis patients in 7 nationwide hospitals in November 2009, and cultured for MRSA colonization. Swabs were inoculated and cultured in 6.5% NaCl tryptic soy broth, then subcultured on MRSASelect medium (Bio-Rad, Hercules, CA) for 20-24 h. Multiplex PCR was performed to analyze staphylococcal cassette chromosome mec (SCCmec) types of MRSA isolates. RESULTS: Of 482 hemodialysis patients, 57 (11.8%) carried MRSA, ranging from 6.7% to 19.0%. Among the 57 MRSA isolates, we identified 3 (5.3%) SCCmec II, 1 (1.8%) SCCmec IIA, 30 (52.6%) SCCmec IIB, 1 (1.8%) SCCmec III, 6 (10.5%) SCCmec IV, and 16 (28.1%) SCCmec IVA subtypes. CONCLUSION: The MRSA carriage rate (11.8%) of hemodialysis patients in this study was high. The SCCmec IIB subtype, a healthcare-associated strain, was the predominant strain, although SCCmec IV isolates, typically found in community-associated MRSA infections, were also frequently observed. To prevent healthcare-associated MRSA infections in hemodialysis patients, standardized infection control measures should be performed, and efforts to reduce MRSA carriage rates should be considered.
