Risk for Invasive MRSA Multiplied 100-Fold in
Patients
Yael Waknine
Source : Medscape
March
9, 2007 — The incidence of invasive methicillin-resistant
Staphylococcus
aureus (MRSA) is 100
times greater among dialysis patients compared with the general population,
according to the results of a study published in the March 9 issue of
the
Morbidity and Mortality Weekly
Report.
Overall
results showed that 813 (15.4%) of 5287 reported invasive MRSA cases occurred in
dialysis patients; the overall incidence was 45.2 cases per 1000 dialysis
patients compared with 0.2 to 0.4 cases per 1000 general
population.
The
majority of infections (86%) were bloodstream infections, mainly occurring in
patients with catheters (85%) or other invasive devices in place at the time;
90% required hospitalization and 17% died as
inpatients.
The
authors note that infections account for nearly 14% of deaths and represent the
second most common cause of mortality in patients with end-stage renal disease,
about 70% of whom require long-term dialysis
treatment.
Although
patients receiving hemodialysis are particularly vulnerable to vascular-access
infections, catheters have the highest risk; intermediate risk for grafts; and
the lowest risk was seen for arteriovenous fistulas. Minimizing long-term
catheter use is therefore a basic strategy for preventing related bacteremias,
including invasive MRSA infections, according to the
authors.
According
to the authors, treatment of hemodialysis-associated infections is a key factor
in the increasing prevalence of antimicrobial resistance. MRSA strains of
healthcare origin (eg, USA100) are typically multidrug resistant; 5 of the first
6 cases of vancomycin-resistant
S
aureus occurred in
patients who had received dialysis and the first was reported in a hemodialysis
patient.
Source : Medscape
March
9, 2007 — The incidence of invasive methicillin-resistant
Staphylococcus
aureus (MRSA) is 100
times greater among dialysis patients compared with the general population,
according to the results of a study published in the March 9 issue of
the
Morbidity and Mortality Weekly
Report.
Overall
results showed that 813 (15.4%) of 5287 reported invasive MRSA cases occurred in
dialysis patients; the overall incidence was 45.2 cases per 1000 dialysis
patients compared with 0.2 to 0.4 cases per 1000 general
population.
The
majority of infections (86%) were bloodstream infections, mainly occurring in
patients with catheters (85%) or other invasive devices in place at the time;
90% required hospitalization and 17% died as
inpatients.
The
authors note that infections account for nearly 14% of deaths and represent the
second most common cause of mortality in patients with end-stage renal disease,
about 70% of whom require long-term dialysis
treatment.
Although
patients receiving hemodialysis are particularly vulnerable to vascular-access
infections, catheters have the highest risk; intermediate risk for grafts; and
the lowest risk was seen for arteriovenous fistulas. Minimizing long-term
catheter use is therefore a basic strategy for preventing related bacteremias,
including invasive MRSA infections, according to the
authors.
According
to the authors, treatment of hemodialysis-associated infections is a key factor
in the increasing prevalence of antimicrobial resistance. MRSA strains of
healthcare origin (eg, USA100) are typically multidrug resistant; 5 of the first
6 cases of vancomycin-resistant
S
aureus occurred in
patients who had received dialysis and the first was reported in a hemodialysis
patient.
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