Nasal colonization with methicillin-resistant Staphylococcus aureus at admission among high-risk Turkish and international patients

Abstract

Objective The aim of this study was to detect the frequency of methicillin-resistant Staphylococcus aureus (MRSA) colonization at admission in a group of presumably high-risk international or Turkish patients referred to our center for elective operations, some of whom were from countries with an unknown prevalence of MRSA infection or colonization. Methods The results of nasal swab screening for MRSA colonization performed using a specific algorithm between 2011 and 2018 in a private medical center were retrospectively reviewed. Presence of MRSA was ascertained using culture and/or real-time polymerase chain reaction (real-time PCR). Results A total of 3,795 patients were included in the study. More than half of the patients were ≤19 years of age (2,094, 55.2%), and MRSA positivity was more common among these patients. Turkish patients constituted 24.5% of the study population. International patients were most frequently referred from Iraq (55.92%), Libya (11.44%), Romania (2.69%), and Bulgaria (1.98%). MRSA positivity was significantly more common among patients referred from other countries when compared to Turkish nationals (11.5% vs. 4.4%, P = 0.00001). Countries with the highest prevalence rates of MRSA colonization were as follows with decreasing order: United Arab Emirates, 25.0%; Georgia, 23.1%; Russia, 22.7%; Iraq, 13.0%, Romania, 12.7%. Other countries with high number of admitted patients (>70 patients) had the following MRSA rates: Turkey, 4.4%; Libya, 6.0%; Bulgaria, 5.3%. Conclusions Although MRSA has a low prevalence in our center, a variation in the rate of MRSA positivity was observed across patients from different countries. Absence hospital acquired contamination or outbreaks in our institution may be attributed to the screening algorithm used and underscores the importance of risk analysis for patients referred from geographical locations with unknown MRSA frequency, to reduce the risk of transmission.

Utility of Methicillin-Resistant Staphylococcus aureus Nares Screening in Hospitalized Children with Acute Infectious Disease Syndromes

“…It needs to be noted, however, that the performance of the MNS (i.e., high NPV) in predicting clinical MRSA infection is intimately related to a low prevalence of MRSA infection in the community [ 10 ]. While it has been shown that a large proportion of children are intermittently colonized with S. aureus , our study, like others, has found only a minority (7.4%) of children being colonized with MRSA [ 11 , 12 , 13 ]. Moreover, of the children in this study with documented growth of S. aureus in clinical culture, MSSA dominated over MRSA (MSSA, 23/30 (76.7%) vs. MRSA, 7/30 (23.3%)), as has also been shown in a recent study of children with invasive S. aureus infections in which MRSA accounted for only one in five of the infections [ 14 ].…”