Nasal and extra nasal MRSA colonization in hemodialysis patients of north-west of Iran

Abstract

Objectives Methicillin resistant Staphylococcus (S.) aureus colonization is one of the main causes of serious infections in hemodialysis patients. This cross-sectional study was performed to examine prevalence of MRSA colonization and evaluation of risk factors in hemodialysis patients. A total of 560 swab samples from nasal, the skin around catheter and throat were collected from 231 hemodialysis patients in Tabriz. The standard biochemical tests were used for identification of S. aureus isolates. Antimicrobial susceptibility profile was determined against 11 antibiotics by the disk diffusion method. Phenotypic test of S. aureus was performed using novobiocin 30 μg/disc, and methicillin sensitivity test was performed by cefoxitin 30 μg/disc. Results Overall, 50.65% (118/231) hemodialysis patients were positive for S. aureus which 34.93% (80/231) of patients were MRSA carriage. The MRSA colonization in patients with a catheter (44.06%) was more than individuals utilizing a fistula (24.57%, p = 0.030). Among sampling sites, the highest MRSA was related to nasal samples (30.70%, p < 0.00001). Extra nasal colonization of S. aureus was observed in 12.71% patients. The highest rates of resistance were observed against ampicillin (93.98%) and the highest sensitivity was against linezolid antibiotic (5.42%). These findings highlight the necessity of prophylaxis against S. aureus in individuals under dialysis.

Pathogens and Prognosis of Deep Neck Infection in End‐Stage Renal Disease Patients

“…Therefore, the most common infectious strain of ESRD‐DNI, MRSA, may be related to dialysis‐associated MRSA colonization and, in the case of particularly poor immunity, causes MRSA infection in the deep cervical spaces. For patients with ESRD, the most common site of MRSA colonization is the upper airway, including the nares and throat, with the skin around the dialysis catheter or fistula the second most common colonization site 31,32 . Therefore, MRSA in the oral cavity may invade the deep neck space through odontogenic infection, which is the most common cause of DNI 3,33 …”

“…For patients with ESRD, the most common site of MRSA colonization is the upper airway, including the nares and throat, with the skin around the dialysis catheter or fistula the second most common colonization site. 31,32 Therefore, MRSA in the oral cavity may invade the deep neck space through odontogenic infection, which is the most common cause of DNI. 3,33 In our study, the positive bacterial culture rate ranged from 35.1% to 62.8%, with a culture latency of approximately 1 week.…”

The molecular characterization of colistin-resistant isolates of Acinetobacter baumannii from patients at intensive care units

“…The DNA extraction was performed by the boiling procedure. The suspension of individual colonies in 300 μL of TE buffer (10 mM Tris, 1 mM EDTA) was boiled at 95ºC for 10 minutes and then centrifuged ( 3 ). The quantity and quality of the extracted DNA were evaluated by spectroscopy at 260 nm and 260/280, respectively.…”

“…The escalating prevalence of antibiotic resistance due to inappropriate antibiotic use and the appearance of multidrug-resistant (MDR), extensively drug-resistant (XDR), and even pan drug-resistant (PDR) strain is now a serious threat in clinical settings ( 3 , 4 ). Based on reports, there is a direct association between the prevalence of MDR and XDR and the high risk of mortality and morbidity in A. baumannii infected patients ( 5 , 6 ).…”

The high cross-transmission in methicillin resistant Staphylococcus aureus between healthy and patient communities

“…MRSA infections are one of the causes of the length of hospital stay and high morbidity and mortality, especially in people with HIV, cancer, diabetes, rheumatoid arthritis, and patients undergoing dialysis ( 6 ). S. aureus colonization is one of the main causes of endogenous infection in hemodialysis patients both time-to-first-bacteremia and the relapse of infection ( 7 ).…”