Meticillin-resistant Staphylococcus aureus and meticillin-susceptible Staphylococcus aureus screening in a cohort of haemodialysis patients: carriage, demographics and outcomes

Price, Amy L.; Sarween, Nadia; Gupta, Ishaan; Baharani, Jyoti

doi:10.1016/j.jhin.2015.01.001

Cited by 27 publications

(13 citation statements)

References 25 publications

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“…A recent meta-analysis suggested that the use of mupirocin is associated with a reduced risk of bacteraemia in a screened population but practice within the UK may vary considerably [6]. For example, a single centre UK study suggested that eradication can be effective in just 36% of individuals but is associated with a reduced risk of MSSA bacteraemia in those who do respond [7]. Screening programmes, eradication therapy and access care policies for both CVC and AVF may vary between centres.…”

Section: Discussionmentioning

confidence: 99%

UK Renal Registry 18th Annual Report: Chapter 12 Epidemiology of Reported Infections amongst Patients Receiving Dialysis for Established Renal Failure in England 2013 to 2014: a Joint Report from Public Health England and the UK Renal Registry

Evans

Caskey²,

Fluck

et al. 2016

Nephron

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Section: Discussionmentioning

confidence: 99%

UK Renal Registry 18th Annual Report: Chapter 12 Epidemiology of Reported Infections amongst Patients Receiving Dialysis for Established Renal Failure in England 2013 to 2014: a Joint Report from Public Health England and the UK Renal Registry

Evans

Caskey²,

Fluck

et al. 2016

Nephron

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“…Genotyping was not performed, likewise, and we cannot distinguish whether the 4 patients who tested positive on more than one occasion were recolonizations by the same strain or acquired a new one. 18 Although the role of decolonization treatment in controlling MRSA is controversial, with some studies showing no effect, others have reported a decrease in subsequent infection rates. 19 There were no decolonization attempts in our MRSA carrier population.…”

Section: Resultsmentioning

confidence: 99%

Low Yield of Methicillin-Resistant Staphylococcus aureus Screening in Hemodialysis Patients: 10 Years’ Experience

Gebreselassie

Kaspar

Droz

et al. 2015

Infect. Control Hosp. Epidemiol.

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OBJECTIVETo determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization in hemodialysis patients and to analyze the cost-effectiveness of our screening approach compared with an alternative strategy.DESIGNScreening study and cost-effectiveness analysis.METHODSAnalysis of twice-yearly MRSA prevalence studies conducted in the hemodialysis unit of a 950-bed tertiary care hospital from January 1, 2004, through December 31, 2013. For this purpose, nasal swab samples were cultured on MRSA screening agar (mannitol-oxacillin biplate).RESULTSThere were 20 mass screenings during the 10-year study period. We identified 415 patients participating in at least 1 screening, with an average of 4.5 screenings per patient. Of 415 screened patients, 15 (3.6%) were found to be MRSA carriers. The first mass screening in 2004 yielded the highest percentage of MRSA (6/101 [6%]). Only 7 subsequent screenings revealed new MRSA carriers, whereas 4 screenings confirmed previously known carriers, and 8 remained negative. None of the carriers developed MRSA bacteremia during the study period. The total cost of our screening approach, that is, screening and isolation costs, was US $93,930. The total cost of an alternative strategy (ie, no mass screening administered) would be equivalent to costs of isolation of index cases and contact tracing was estimated to be US $5,382 (difference, US $88,548).CONCLUSIONSIn an area of low MRSA endemicity (<5%), regular nasal screenings of a high-risk population yielded a low rate of MRSA carriers. Twice-yearly MRSA screening of dialysis patients is unlikely to be cost-effective if MRSA prevalence is low.Infect. Control Hosp. Epidemiol. 2015;36(9):1046–1049

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“…14,15 However, two studies demonstrated similar carriage rates of S. aureus in hemodialysis patients including Verhoeven et al (58%) 16 and Price et al (49%). 17 The risk of infections in nasal carriers of this microorganism is real and well defined. 18 It is important to point out that the small number…”

Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Staphylococcus aureus Isolates Obtained from Hemodialyzed Patients at the Hospital de Clínicas of Paraguay: A pilot study

et al. 2017

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Background: Patients undergoing hemodialysis are susceptible to the nasal carriage of Staphylococcus aureus, increasing the risk of developing infections associated with higher morbidity and mortality. The objective of this study was to describe the frequency of S. aureus carriage in hemodialysis patients and to perform molecular analysis of isolates by applying multiple-locus variable analysis. Methods: We conducted a descriptive cross sectional study with non-probabilistic sampling that included 28 hemodialysis patients attending the Nephrology Department of Hospital de Clínicas in Asunción, Paraguay. We obtained clinical data from medical records and interviews with patients. Nasal swabs were collected and analyzed by microbiological and molecular methods. Results: The frequency of S. aureus carriage was 50% (14/28), 93% of which (13/14) were methicillin resistant, 57% (6/14) were gentamicin resistant and 36% (5/14) were resistant to more than 4 antibiotic classes. S. aureus carriers showed higher frequency of rhinitis (p=0.02 odds ratio [OR]=6.6 (1.2- 34.4)). Seven methicillin-resistant S. aureus isolates had been analyzed by multiple-locus variable analysis, two of them showed identical pattern bands. Conclusion: We found a high frequency of methicillin-resistant Staphylococcus aureus colonization and the presence of two isolates with identical profile in the multiple-locus variable analysis indicating the possibility of transmission between patients.

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Meticillin-resistant Staphylococcus aureus and meticillin-susceptible Staphylococcus aureus screening in a cohort of haemodialysis patients: carriage, demographics and outcomes

Cited by 27 publications

References 25 publications

UK Renal Registry 18th Annual Report: Chapter 12 Epidemiology of Reported Infections amongst Patients Receiving Dialysis for Established Renal Failure in England 2013 to 2014: a Joint Report from Public Health England and the UK Renal Registry

UK Renal Registry 18th Annual Report: Chapter 12 Epidemiology of Reported Infections amongst Patients Receiving Dialysis for Established Renal Failure in England 2013 to 2014: a Joint Report from Public Health England and the UK Renal Registry

Low Yield of Methicillin-Resistant Staphylococcus aureus Screening in Hemodialysis Patients: 10 Years’ Experience

Molecular Characterization of Staphylococcus aureus Isolates Obtained from Hemodialyzed Patients at the Hospital de Clínicas of Paraguay: A pilot study

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