Prevalence of and risk factors for colonisation with meticillin-resistant Staphylococcus aureus at the time of hospital admission
Abstract number: P652
Antoniadou A., Pliarchopoulou F., Plachouras D., Karaiskos E., Atmatzidou S., Protopapas K., Tsikrika S., Kouvelas K., Moschona E., Athanasia S., Zafiraki A., Papadomichelakis E., Giamarellou H.
Objective: To determine the prevalence of MRSA colonisation among patients presenting for hospital admission, its correlation with community-acquired MRSA (CA-MRSA) prevalence and to identify risk factors for MRSA colonisation
Methods: In a tertiary teaching hospital, surveillance cultures from the nares, axilla and inguinal areas were performed at the time of admission for all patients except those admitted in the oncology and hematology unit. Demographic information and possible risk factors for colonisation were also recorded.
Results: Swab samples were collected from 937 patients presenting for admission in a year. Patients lived in urban areas in 87%, had a mean age of 57years (median 63) and a female to male ratio of 1.1:1. Staphylococcus aureus was isolated from 142 (15.1%) patients and MRSA from 30 (3.2%) of the patients (20% of colonising isolates). Detection of colonisation was 88.7% in the nares, 40.8% in the axilla and 51.4% in the inguinal area. In 3 (2.7.%) and 7 (4.9%) colonisation was only evident in the axilla and inguinal area respectively. All colonising MRSA isolates exhibited in their sensitivity tests the pattern expected for CA-MRSA with the majority of them sensitive to cotrimoxazole, clindamycin, minocycline, rifampin and quinolones. Interestingly tetracycline and fucidic acid were inactive in the majority of strains. In the multivariate analysis comparing MRSA-colonised to MSSA-colonised patients, independent predictors of MRSA colonisation were: age <50 (p = 0.017), the presence of an indwelling urinary catheter (p = 0.036), the absence of hospitalisation the preceding year (p = 0.02) and the presence of skin disease (p = 0.009).
Conclusion: Colonisation with MRSA of patients admitted to the hospital is low and probably reflects the prevalence of colonisation with CA-MRSA in the community. Risk factors for MRSA acquisition do not correlate with previous contact with healthcare facilities but with younger age, skin diseases (affecting skin integrity) and debilitating conditions (as expressed by the presence of an indwelling urinary catheter). Larger sample of data may be required to further explore risk factors associated with MRSA colonisation in the community.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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