Background: Nasal colonization with Methicillin-resistant Staphylococcus aureus (MRSA) can predispose to subsequent infections in surgical and non-surgical patients, making the management challenging with increased rates of morbidity, mortality and cost burden. Objectives: The present study was carried out to evaluate the risk factors of MRSA nasal colonization in preoperative patients in Azadi Teaching Hospital in Duhok Province - Kurdistan Region-Iraq. Methods: Nasal swabs were obtained from 150 patients after completing a questionnaire. Conventional laboratory methods were carried out to identify Staphylococcus aureus (S. aureus) and antimicrobial susceptibility test was conducted for recognizing MRSA isolates. Results: A total of 41 (27.3%) of 150 patients were MRSA carriers. The mean age of participants MRSA carriers was 35.27±20.40 years old. The highest prevalence rate of nasal colonization with MRSA was in males (27.94%) than females (26.82%). In logistic regression analysis, no significant differences was detected between MRSA carriage and the associated risk factors including age [OR: 0.99 (95 % CI: 0.97- 1.01); P = 0.45], gender [OR: 1.05 (95 % CI: 0.51- 2.17); P = 0.87] and medical comorbidities [OR: 1.11 (95 % CI: 0.42- 2.92); P = 0.82]. Conclusions: Age, gender and medical comorbidities were not associated common risk factors for nasal colonization of MRSA in preoperative patients. This study should be considered preliminary and studies with larger sample sizes and with using advance molecular tools are needed in the future.
We have read, with great interest, the study conducted by Bano et al. (1) in your journal. The aim of their study was to investigate the prevalence of thrombocytopenia in HCV patients without cirrhosis and splenomegaly. They recruited 30 patients for the study, and found the prevalence of thrombocytopenia to be 43.3%. Moreover, they concluded that thrombocytopenia was of moderate frequency in HCV participants. Undoubtedly, HCV is a public health problem worldwide, especially in developing countries (2, 3). The classical treatment of HCV is challenging and fraught with poor tolerability and side effects. A major breakthrough occurred in managing HCV with new direct acting antiviral regimens with less side effects and more tolerability. However, the use of such new regimens is restricted due to their high price; therefore, classification of the patients is necessary (4). Here comes the importance of thrombocytopenia, as it can be considered a contraindication for the classical regimen (5, 6). Any patient with thrombocytopenia might be eligible for the new expensive medications. Hence, it might be important for the public health planners to estimate the prevalence of thrombocytopenia in HCV. Furthermore, thrombocytopenia in chronic HCV patients is associated with bleeding tendency, and it is a poor prognostic factor. However, it is important to clarify that HCV-antibody positivity does not indicate current infection, but shows an exposure to the virus. To a large extent, the diagnosis of HCV depends on the PCR positivity. Thus, any study targeting HCV patients should include patients with confirmed PCR results. Moreover, a larger sample size is needed for prevalence study. Therefore, the recruitment of a larger sample with a confirmed current HCV infection is highly recommended.
We have read, with great interest, the study conducted by Bano et al. (1) in your journal. The aim of their study was to investigate the prevalence of thrombocytopenia in HCV patients without cirrhosis and splenomegaly. They recruited 30 patients for the study, and found the prevalence of thrombocytopenia to be 43.3%. Moreover, they concluded that thrombocytopenia was of moderate frequency in HCV participants. Undoubtedly, HCV is a public health problem worldwide, especially in developing countries (2, 3). The classical treatment of HCV is challenging and fraught with poor tolerability and side effects. A major breakthrough occurred in managing HCV with new direct acting antiviral regimens with less side effects and more tolerability. However, the use of such new regimens is restricted due to their high price; therefore, classification of the patients is necessary (4). Here comes the importance of thrombocytopenia, as it can be considered a contraindication for the classical regimen (5, 6). Any patient with thrombocytopenia might be eligible for the new expensive medications. Hence, it might be important for the public health planners to estimate the prevalence of thrombocytopenia in HCV. Furthermore, thrombocytopenia in chronic HCV patients is associated with bleeding tendency, and it is a poor prognostic factor. However, it is important to clarify that HCV-antibody positivity does not indicate current infection, but shows an exposure to the virus. To a large extent, the diagnosis of HCV depends on the PCR positivity. Thus, any study targeting HCV patients should include patients with confirmed PCR results. Moreover, a larger sample size is needed for prevalence study. Therefore, the recruitment of a larger sample with a confirmed current HCV infection is highly recommended.
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