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Korean J Nosocomial Infect Control. 2013 Dec;18(2):51-56. Korean. Original Article. https://doi.org/10.14192/kjnic.2013.18.2.51
Kim JS , Lee SH , Jeong J , Roh KH , Lee HK , Jang SJ , Lee HS , Kim JU , Lee SH , Yeom JS , Lee SO , Choi JS , Yoo SY , Jeong JS , Kim MN .
Department of Laboratory Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea.
Neodin Medical Institute, Seoul, Korea.
Department of Laboratory Medicine, University of Ulsan and Ulsan University Hospital, Ulsan, Korea.
Department of Laboratory Medicine, Korea University College of Medicine, Anam Hospital, Seoul, Korea.
Department of Laboratory Medicine, The Catholic University of Korea College of Medicine, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.
Department of Laboratory Medicine, Chosun University College of Medicine, Gwangju, Korea.
Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Korea.
Department of Laboratory Medicine, University of Ulsan College of Medicine and Gangnung Asan Hospital, Gangnung, Korea.
Department of Laboratory Medicine, Hanmaeum General Hospital, Jeju, Korea.
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
Nursing College, Gachon University, Incheon, Korea.
Infection Control Office, The Catholic University of Korea College of Medicine, St. Vincent's Hospital, Suwon, Korea.
Department of Clinical Nursing, University of Ulsan College of Medicine, Ulsan, Korea.
Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. mnkim@amc.seoul.kr
Abstract

BACKGROUND: Staphylococcus aureus is a major bacteremia-causing pathogen in hemodialysis patients, frequently colonizing patient skin and mucosa. Active infection control is necessary to prevent methicillin-resistant S. aureus (MRSA) infection in hospitals; however, the spread of community-associated MRSA has recently become a concern for MRSA infection control. We evaluated the nasal colonization of MRSA among hemodialysis patients and the molecular characterization of the MRSA isolates. METHODS: Nasal swabs were obtained from 482 hemodialysis patients in 7 nationwide hospitals in November 2009, and cultured for MRSA colonization. Swabs were inoculated and cultured in 6.5% NaCl tryptic soy broth, then subcultured on MRSASelect medium (Bio-Rad, Hercules, CA) for 20-24 h. Multiplex PCR was performed to analyze staphylococcal cassette chromosome mec (SCCmec) types of MRSA isolates. RESULTS: Of 482 hemodialysis patients, 57 (11.8%) carried MRSA, ranging from 6.7% to 19.0%. Among the 57 MRSA isolates, we identified 3 (5.3%) SCCmec II, 1 (1.8%) SCCmec IIA, 30 (52.6%) SCCmec IIB, 1 (1.8%) SCCmec III, 6 (10.5%) SCCmec IV, and 16 (28.1%) SCCmec IVA subtypes. CONCLUSION: The MRSA carriage rate (11.8%) of hemodialysis patients in this study was high. The SCCmec IIB subtype, a healthcare-associated strain, was the predominant strain, although SCCmec IV isolates, typically found in community-associated MRSA infections, were also frequently observed. To prevent healthcare-associated MRSA infections in hemodialysis patients, standardized infection control measures should be performed, and efforts to reduce MRSA carriage rates should be considered.

Copyright © 2019. Korean Association of Medical Journal Editors.