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Prevalence of Colonization With Community-Associated Methicillin-Resistant Staphylococcus aureus Among End-Stage Renal Disease Patients and Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Leonard B. Johnson ,
Jinson Jose ,
Farah Yousif ,
Joan Pawlak  and
Louis D. Saravolatz
Leonard B. Johnson*
Affiliation:
St. John Hospitaland Medical Center, Detroit, Michigan Wayne State University, Detroit, Michigan
Jinson Jose
Affiliation:
St. John Hospitaland Medical Center, Detroit, Michigan
Farah Yousif
Affiliation:
St. John Hospitaland Medical Center, Detroit, Michigan
Joan Pawlak
Affiliation:
St. John Hospitaland Medical Center, Detroit, Michigan
Louis D. Saravolatz
Affiliation:
St. John Hospitaland Medical Center, Detroit, Michigan Wayne State University, Detroit, Michigan
*
19251 Mack Avenue, Grosse Pointe Woods, MI 48236 (leonard.johnson@stjohn.org)
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Abstract

Objective.

To evaluate the prevalence, epidemiologic features, and molecular characteristics of colonization with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among hospitalized dialysis patients and their healthcare workers (HCWs).

Design.

Prospective observational clinical and laboratory study of nasal colonization.

Setting.

A 600-bed urban academic medical center.

Subjects.

One hundred twenty hospitalized dialysis inpatients and 100 HCWs.

Results.

Of 120 patients, 40 (33%) were colonized with S. aureus; 26 (65%) of these 40 were colonized with MRSA. Among the 26 MRSA isolates, 10 (38.5%) carried staphylococcal cassette chromosome (SCC) mec type IV (ie, CA-MRSA), and 7 of these 10 carried the genes for the Panton-Valentine leukocidin (PVL) toxin. Patients colonized with healthcare-associated MRSA strains and those colonized with CA-MRSA strains were similar, except for a higher frequency of a history of congestive heart failure among those with healthcare-associated MRSA strains (P = .014). Among 10 patients who presented with or developed an S. aureus infection while hospitalized, 8 were colonized with S. aureus, 7 with MRSA, and 3 with SCCmec type IV strains. Among 100 HCWs, 31 were colonized with S. aureus, including 6 with MRSA; 2 of the MRSA isolates belonged to CA-MRSA strains, and soft-tissue infections were reported in one of the HCWs and in the family member of the other HCW colonized with these strains.

Conclusions.

There is a high rate of colonization with MRSA and CA-MRSA among hospitalized dialysis patients and their HCWs. As other studies have found, it appears that individuals are being colonized with both CA-MRSA strains and healthcare-associated MRSA strains.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 1 , January 2009 , pp. 4 - 8
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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