Comparison between patients under hemodialysis with community-onset bacteremia caused by community-associated and healthcare-associated methicillin-resistant Staphylococcus aureus strains (original) (raw)
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PloS one, 2018
Methicillin-resistant Staphylococcus aureus (MRSA) infections in the hemodialysis (HD) population are epidemiologically classified as healthcare-associated infections. The data about the clinical impact and bacterial characteristics of hospital-onset (HO)- and community-onset (CO)-MRSA in HD patients are scarce. The current study analyzed the difference in the clinical and molecular characteristics of HO-MRSA and CO-MRSA. We performed a retrospective review and molecular analysis of clinical isolates from 106 HD patients with MRSA bacteremia from 2009 to 2014. CA genotypes were defined as isolates carrying the SCCmec type IV or V, and HA genotypes were defined as isolates harboring SCCmec type I, II, or III. CO-MRSA infections occurred in 76 patients, and 30 patients had HO-MRSA infections. There was no significant difference in the treatment failure rates between patients with CO-MRSA infections and those with HO-MRSA infections. CA genotypes were associated with less treatment fai...
Clinical Infectious Diseases, 2013
Incidence of invasive MRSA infections, mostly bloodstream infections, decreased substantially among dialysis patients from 2005-2011 based on surveillance data from 9 metropolitan areas. Despite decreases, an estimated 15,169 invasive MRSA infections occurred in U.S. dialysis patients in 2011. Abstract Background Approximately 15,700 invasive methicillin-resistant Staphylococcus aureus (MRSA) infections occurred in U.S. dialysis patients in 2010. Frequent hospital visits and prolonged bloodstream access, especially via central venous catheters (CVCs), are risk factors among hemodialysis patients. We describe the epidemiology of and recent trends in invasive MRSA infections among dialysis patients.
Bacterial Empire
The carriage of methicillin-resistant Staphylococcus aureus (MRSA) among dialysis patients is remarkable not only in terms of the risks of developing infections, but also in playing a principle part in transmission among dialysis unit staff. The aim of this study was to detect the colonization of Methicillin-sensitive Staphylococcus aureus and MRSA carriage. Also, our aim was to determine the relatedness of MRSA isolates and the potential routes of transmission using PCR- Restriction Fragment Length Polymorphism (PCR-RFLP) in Hemodialysis Unit of El Zagazig General Hospital, a tertiary medical center in Sharqia, Egypt. This study was conducted on 150 chronic hemodialysis outpatients and 200 non clinical control samples including environmental and healthcare workers (HCWs). Antibiotic susceptibility by VITEK-2 and disc diffusion, PCR amplification of mecA, pvl and coa genes and RFLP-PCR were conducted during the study period. In this study 3.3% of the patients and 3.2% of HCWs coloni...
Methicillin-resistant Staphylococcus aureus bacteremia in hemodialysis and nondialysis patients
Journal of Microbiology Immunology and Infection, 2014
prevalence of vancomycin MIC of 2 mg/mL was observed in hemodialysis group in comparison with nondialysis group (11.4% vs. 1.7%, p Z 0.016). In following analyses of hemodialysis group, patients with initial presentation of septic shock had a higher risk of vancomycin MIC of 2 mg/ mL than nonseptic shock patients (100.0% vs. 38.5% p Z 0.014). Infection-related mortality was associated with age, Acute Physiology and Chronic Health Evaluation II (APACHE-II) score >15, presence of septic shock, receipt of mechanical ventilation, and failure to remove source of bacteremia in univariate analysis. Conclusion: Hemodialysis patients with MRSA bacteremia are more likely to have a high vancomycin MIC (2 mg/mL) compared with nondialysis patients. Infection-related mortality is associated with the patient's clinical manifestations, including age, APACHE-II score >15, presence of septic shock, receipt of mechanical ventilation, and failure to remove source of bacteremia. Treatment selection should be tailored according to the patient's clinical condition.
American Journal of Infection Control, 2010
To compare demographic and clinical characteristics, and methicillin-resistant Staphylococcus aureus (MRSA) strain characteristics, in patients with early-onset (EO) and late-onset (LO) MRSA nosocomial pneumonia. Methods: This was a retrospective analysis of data from a multicenter observational study of nosocomial pneumonia patients admitted between November 2008 and July 2010. Laboratory analyses performed on MRSA isolates included confirmation of antimicrobial susceptibility and heteroresistance to vancomycin, USA typing, staphylococcal cassette chromosome (SCC) mec typing, and detection of Panton-Valentine leukocidin (PVL) genes. Results: We identified 134 patients; 42 (31%) had EO MRSA pneumonia and 92 (69%) had LO MRSA pneumonia. The patients in the LO group were more likely to have risk factors for multidrug-resistant pathogens (98% vs. 76%, p < 0.001). The MRSA USA300 strain was found with equal frequency in the EO and LO groups. Likewise, both groups had similar frequencies of isolates exhibiting PVL and SCCmec type IV. Conclusions: Our findings provide further evidence of the continued migration of community-associated MRSA into the healthcare setting in the USA. MRSA USA300 genotype has emerged as a significant cause of LO nosocomial pneumonia in intensive care units. Appropriate anti-MRSA antimicrobial therapy should be considered for both EO and LO hospital-acquired pneumonia and ventilator-associated pneumonia.
Infection Control and Hospital Epidemiology, 2005
Objective: Comorbid conditions have complicated previous analyses of the consequences of methicillin resistance for costs and outcomes of Staphylococcus aureus bacteremia. We compared costs and outcomes of methicillin resistance in patients with S. aureus bacteremia and a single chronic condition. Design, Setting, and Patients: We conducted a prospective cohort study of hemodialysis-dependent patients with end-stage renal disease and S. aureus bacteremia hospitalized between July 1996 and August 2001. We used propensity scores to reduce bias when comparing patients with methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) S. aureus bacteremia. Outcome measures were resource use, direct medical costs, and clinical outcomes at 12 weeks after initial hospitalization. Results: Fifty-four patients (37.8%) had MRSA and 89 patients (62.2%) had MSSA. Compared with patients with MSSA bacteremia, patients with MRSA bacteremia were more likely to have acquired the infection while ho...
Epidemiology of Staphylococcus aureus Infections in Patients on Hemodialysis
Infection Control and Hospital Epidemiology, 1994
We observed pediatric S. aureus hospitalizations decreased 36% from 26.3 to 16.8 infections per 1,000 admissions from 2009 to 2016, with methicillin-resistant S. aureus (MRSA) decreasing by 52% and methicillin-susceptible S. aureus decreasing by 17%, among 39 pediatric hospitals. Similar decreases were observed for days of therapy of anti-MRSA antibiotics.
American Journal of Infection Control, 2011
Background: This study was coinducted to investigate Staphylococcus aureus carriage in patients undergoing hemodialysis and peritoneal dialysis and to evaluate the clonal relationship between carriage and clinical isolates. Methods: Surveillance for S aureus carriage was performed in 30 hemodialysis patients, 40 peritoneal dialysis patients, 13 workers in the unit, and 40 controls. The clonal relatedness of isolates was assessed by pulsed-field gel electrophoresis. Results: Screening cultures yielded 8 (26.6%) isolates from the hemodialysis patients, 9 (22.5%) from the peritoneal dialysis patients, 4 (30.7%) from the staff, and 8 (20%) from the controls. All of the isolates were methicillin-susceptible except one from a hemodialysis patient. There was no significant difference in carriage rate among the study groups. A history of hospital admission in the previous 6 months and a history of infection was associated with an increased carriage rate. A total of 23 genotypes were established for the 28 isolates, demonstrating high clonal heterogenecity. Six clinical isolates from 4 hemodialysis patients and 4 clinical isolates from two peritoneal dialysis patients were molecularly evaluated to compare isolates obtained from infection with carriage isolates of the same patients. All but one of these clinical isolates were ''indistinguishable/closely related'' to the isolates obtained from the same patients as carriage isolates. Conclusion: Opur data show a clear association between S aureus carriage and S aureus infection. Determining the S aureus carriage state of patients undergoing dialysis can help guide infection prevention measures and treatment strategies.