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Prevalence of Colonization With Community-Associated Methicillin-Resistant Staphylococcus aureus Among End-Stage Renal Disease Patients and Healthcare Workers

  • Leonard B. Johnson (a1) (a2), Jinson Jose (a1), Farah Yousif (a1), Joan Pawlak (a1) and Louis D. Saravolatz (a1) (a2)...
Abstract
Objective.

To evaluate the prevalence, epidemiologic features, and molecular characteristics of colonization with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among hospitalized dialysis patients and their healthcare workers (HCWs).

Design.

Prospective observational clinical and laboratory study of nasal colonization.

Setting.

A 600-bed urban academic medical center.

Subjects.

One hundred twenty hospitalized dialysis inpatients and 100 HCWs.

Results.

Of 120 patients, 40 (33%) were colonized with S. aureus; 26 (65%) of these 40 were colonized with MRSA. Among the 26 MRSA isolates, 10 (38.5%) carried staphylococcal cassette chromosome (SCC) mec type IV (ie, CA-MRSA), and 7 of these 10 carried the genes for the Panton-Valentine leukocidin (PVL) toxin. Patients colonized with healthcare-associated MRSA strains and those colonized with CA-MRSA strains were similar, except for a higher frequency of a history of congestive heart failure among those with healthcare-associated MRSA strains (P = .014). Among 10 patients who presented with or developed an S. aureus infection while hospitalized, 8 were colonized with S. aureus, 7 with MRSA, and 3 with SCCmec type IV strains. Among 100 HCWs, 31 were colonized with S. aureus, including 6 with MRSA; 2 of the MRSA isolates belonged to CA-MRSA strains, and soft-tissue infections were reported in one of the HCWs and in the family member of the other HCW colonized with these strains.

Conclusions.

There is a high rate of colonization with MRSA and CA-MRSA among hospitalized dialysis patients and their HCWs. As other studies have found, it appears that individuals are being colonized with both CA-MRSA strains and healthcare-associated MRSA strains.

Copyright
Corresponding author
19251 Mack Avenue, Grosse Pointe Woods, MI 48236 (leonard.johnson@stjohn.org)
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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