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Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Infection Among Patients With End-Stage Renal Disease

Published online by Cambridge University Press:  21 June 2016

Leonard B. Johnson ,
Anilrudh A. Venugopal ,
Joan Pawlak  and
Louis D. Saravolatz
Leonard B. Johnson*
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan Wayne State University School of Medicine, Detroit, Michigan
Anilrudh A. Venugopal
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan
Joan Pawlak
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan
Louis D. Saravolatz
Affiliation:
Department of Internal Medicine, St. John Hospital and Medical Center, Detroit, Michigan Wayne State University School of Medicine, Detroit, Michigan
*
19251 MackAvenue, Suite 340, Grosse Pointe Woods, Michigan 48236, (leonard.johnson@stjohn.org)
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Extract

Objective.

To evaluate the frequency of infections due to community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains among our patients with end-stage renal disease.

Design.

Prospective observational clinical and laboratory study of patients in 2005. Molecular features of isolates recovered from these patients were compared with those of isolates recovered in 2000 from patients with end-stage renal disease.

Setting.

A 600-bed urban academic medical center.

Patients.

Thirty-two patients with end-stage renal disease and MRSA infection at the time of hospitalization from 2005 were evaluated. For comparison, laboratory analysis was performed for 17 MRSA isolates recovered from patients with end-stage renal disease in 2000.

Results.

The patients from 2005 were more likely than the patients from 2000 to have infection with strains that carried the staphylococcal cassette chromosome (SCC) mec type IV complex (50% vs 11.8%; relative risk, 4.25 [95% confidence interval, 1.17-25.98]; P = .012) and the Panton-Valentine leukocidin toxin genes (25% vs 0%; P = .038). Eight patients from 2005 were infected with a strain that is identical to MRSA clone USA300 in terms of molecular type and presence of SCCmec type IV and Panton-Valentine leukocidin genes. Among the patients from 2005, those infected with SCCmec type IV strains (ie, CA-MRSA strains) and those infected with SCCmec type II strains (ie, healthcare-associated MRSA [HA-MRSA] strains) were similar with respect to demographic characteristics, risk factors, and outcomes.

Conclusions.

We documented an increased proportion of infections with CA-MRSA strains, including clone USA300, among our population of patients undergoing dialysis. Patients infected with CA-MRSA strains and HA-MRSA strains were similar with respect to presenting illness and outcomes.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 10 , October 2006 , pp. 1057 - 1062
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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