World Journal of Medical Sciences 9 (4): 239-242, 2013
ISSN 1817-3055
© IDOSI Publications, 2013
DOI: 10.5829/idosi.wjms.2013.9.4.8178
Corresponding Author: Javad Alizargar, Kashan University of Medical Sciences, Kashan, Iran.
Tel: +98 913 5339790, Fax: +98 361 5579028.
239
Prevalence and Antibiotic Susceptibility Profile of MRSA Strains
Isolated from Anterior Nares of Hemodialysis Patients
Mohammad Reza Sharif, Javad Alizargar and Alireza Sharif
1 2 3
Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran
1
Kashan University of Medical Sciences, Kashan, Iran
2
Department of Infectious Disease,
3
Kashan University of Medical Sciences, Kashan, Iran
Abstract: Patients with End Stage Renal Disease on maintenance hemodialysis are at a greater risk for
bacterial infection particularly Staphylococcus aureus (S. aureus). Methicillin-resistant S. aureus (MRSA) is
a challenge in clinical practice nowadays, because they resist a great range of antibiotics. This study mainly
designed in order to determine the prevalence MRSA in anterior nares samples of hemodyalisis patients. The
results of this study show that 153 (59.8%) out of 256 patients who had admitted for hemodialysis were
colonized with S. aureus and more than half of these colonizations (51.6%) were with MRSA. Emerging of
MRSA isolates that are resistant to vancomycin, as we found one in our study, can be an alarm for clinical
practice.
Key words: Staphylococcus aureus Methicillin-Resistant Staphylococcus aureus Vancomycin Resistance
INTRODUCTION MRSA colonization may lead to infection and there
Patients with End Stage Renal Disease (ESRD) on MRSA develop skin or soft tissue infection in 8-10 weeks
maintenance hemodialysis are at a greater risk for bacterial [13]. Infections caused by MRSA strains are associated
infection, particularly Staphylococcus aureus (S. aureus) with longer hospital stay, prolonged antibiotic
infection [1]. Infection remains a major cause of morbidity administration and higher cost than infections caused by
and mortality among patients with ESRD [2]. Rate of methicillin-susceptible S. aureus strains [8].
resistance to different antibiotics are increasing every day This study mainly designed in order to determine the
moreover, unwise use of even last lines of treatment prevalence of S. aureus colonization and MRSA rate in
antibiotics such as vancomycin worsen the situation [3]. anterior nares samples of hemodialysis patients admitted
Methicillin-resistant S. aureus (MRSA) challenge the in Alzahra Hospital from Jan 2012 to June 2013. It also
clinical practice nowadays, because they resist a great assesses the resistance rate of MRSA to different
range of antibiotics [4-12]. Vancomycin is the last line of antibiotics.
treatment antibiotic in ESRD patients but MRSA isolates
have shown resistance to this antibiotics and reports of MATERIALS AND METHODS
this resistant have been published by the authors [8, 9,
12]. This prospective study was conducted at Alzahra
Patients with ESRD are at increased risk for hospital. Eligible patients were 18 years or older and
infection and colonization with methicillin-resistant receiving hemodialysis continuously for at least 8 weeks
S. aureus (MRSA) because they are repeatedly before enrollment using a native-vessel fistula. Patients
exposed to the healthcare environment and often were excluded if they had S. aureus infection within 3
receive prolonged courses of antibiotics, besides being months of study entry, severe viral or bacterial infection,
immunocompromised [2]. HIV infection, current use of immunosuppressive or
are some reports that 38% of individuals with colonized