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Methicillin‐resistant S taphylococcus aureus carriage in hospitalized chronic hemodialysis patients and its predisposing factors
Author(s) -
Yeoh Lee Ying,
Tan Feng Ling Grace,
Willis George Christopher,
Ooi Say Tat
Publication year - 2014
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12061
Subject(s) - medicine , hemodialysis , carriage , colonization , diabetes mellitus , retrospective cohort study , methicillin resistant staphylococcus aureus , staphylococcus aureus , medical record , genetics , pathology , bacteria , microbiology and biotechnology , biology , endocrinology
There has been a paucity of literature on methicillin‐resistant S taphylococcus aureus ( MRSA ) colonization in chronic hemodialysis patients who required admission. The purpose of this study is to determine the MRSA carriage rate in hospitalized chronic hemodialysis patients, to identify the risk factors, and assess the consequences of MRSA colonization. This was a retrospective study of hospitalized chronic hemodialysis patients at K hoo T eck P uat H ospital from J uly 1, 2010 to J une 30, 2011. MRSA screening was done on the day of admission using culture method with MRSA select ( B io‐ R ad)™. The patients were divided into two groups: MRSA carriers and noncarriers. Demographic data, medical, and laboratory information was obtained via electronic medical record system. Outcome measures were infection rates during current hospitalization episode, frequency of hospitalization, and cumulative hospitalization days per year. Prevalence rate of MRSA colonization in hospitalized chronic hemodialysis patients was 15.1%, compared to all admitted patients (5.8%). Diabetes mellitus, M alay ethnicity, shorter hemodialysis duration and use of tunneled hemodialysis catheters were associated with MRSA colonization (P < 0.05). Relative risk of infection during the episode of admission among MRSA carriers was 3.2‐fold compared to noncarriers. MRSA colonization rates tend to be higher in patients on hemodialysis for less than 3 years and it correlates with longer hospitalization after adjustment for other variables (P < 0.05). Patients on chronic hemodialysis requiring admission have higher rates of MRSA colonization. The risk factors of MRSA carriers and the correlation of MRSA rates to longer hospitalization suggest its nosocomial origin in this group of patients.