Risk factors for nasal carriage of methicillin-resistant Staphylococcus aureus among patients with end-stage renal disease in Taiwan

J Formos Med Assoc. 2012 Jan;111(1):14-8. doi: 10.1016/j.jfma.2012.01.001. Epub 2012 Jan 30.

Abstract

Background/purpose: Patients with end-stage renal disease (ESRD) are at particular risk for methicillin-resistant Staphylococcus aureus (MRSA) infections, especially via nasal colonization of MRSA. Surveillance cultures are recommended to identify patients colonized by MRSA.

Methods: Clinical data and screening cultures of S. aureus from the anterior nares of 541 patients on long-term dialysis in the hospitals were performed in March 2007. The follow-up survey was conducted 1 year later.

Results: A total of 32 (5.9%) of the 541 patients were positive nasal cultures for MRSA, while 89 (16.5%) were positive for methicillin-susceptible S. aureus (MSSA). In a multivariate analysis, risk factors for ESRD patients with MRSA colonization included congestive heart failure, nursing home admission, and nasogastric tube feeding in the last 3 months. Follow-up of the 32 MRSA colonized patients showed that one (3.1%) died due to MSSA and three (9.3%) died due from MRSA infection.

Conclusions: We found that patients with ESRD and MRSA nasal colonization were associated with a history of congestive heart failure, nursing home admission, and nasogastric tube feeding in the last 3 months.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Carrier State / epidemiology
  • Case-Control Studies
  • Community-Acquired Infections / diagnosis*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Kidney Failure, Chronic / complications*
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Middle Aged
  • Multivariate Analysis
  • Nasal Cavity / microbiology*
  • Prognosis
  • Risk Factors
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology*
  • Taiwan / epidemiology
  • Young Adult

Substances

  • Anti-Bacterial Agents