Patients with Rheumatic Diseases do not have an Increased Risk of MRSA Carrier Status
Tóm tắt
The aim of this study was to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) both in rheumatologic and non-rheumatologic rehabilitation centers. In addition, we sought to evaluate the practice value of existing screening recommendations of the German Commission for Hospital Hygiene and Infection Prevention (KRINKO). The analysis was performed in four rehabilitation clinics (rheumatology, psychosomatic medicine, oncology, and cardiology) with at least 200 patients per clinic tested for MRSA. Nine (1.1%) of the 842 patients were colonized with MRSA. Only five of them should have been tested according to the commission’s recommendations. The prevalence was 0.5% (n = 207) in rheumatologic, 0.9% (n = 224) in psychosomatic, 1.4% (n = 209) in oncologic and 1.5% (n = 202) in cardiologic patients. We found a greater exposure to risk factors in cardiologic and oncologic patients. Among patients with carrier status, a higher percentage was exposed to three potential risk factors not applied by the commission. The prevalence of MRSA in our cohort correlates with data from previous studies. The low percentage among rheumatologic patients suggests that they are not more likely to reveal MRSA carrier status than other patient groups and that long-term immunosuppression does not necessarily represent a risk factor for MRSA colonization. Since only five out of nine patients with carrier status would have been detected following the recommendations of the KRINKO, further studies on potential risk factors are warranted.
Tài liệu tham khảo
Huang SS, Hinrichsen VL, Datta R, Spurchise L, Miroshnik I, Nelson K, et al. Methicillin-resistant Staphylococcus aureus infection and hospitalization in high-risk patients in the year following detection. PLoS ONE. 2011;6(9):e24340. https://doi.org/10.1371/journal.pone.0024340.
Roth VR, Longpre T, Coyle D, Suh KN, Taljaard M, Muldoon KA, et al. Cost analysis of universal screening vs. risk factor-based screening for methicillin-resistant Staphylococcus aureus (MRSA). PLoS ONE. 2016;11(7):e159667.
Chowers M, Carmeli Y, Shitrit P, Elhayany A, Geffen K. Cost analysis of an intervention to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission. PLoS One. 2015;10(9):e0138999. https://doi.org/10.1371/journal.pone.0138999 (eCollection 2015).
Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen; Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut. [Recommendations for the prevention and control of methicillin-resistant Staphylococcus aureus strains (MRSA) in medical and nursing facilities; recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) of the Robert-Koch-Institute.] Bundesgesundheitsblatt—Gesundheitsforschung—Gesundheitsschutz. 2014; 57:696–732. doi:10.1007/s00103-014-1980-x (in German).
Heudorf U, Färber D, Mischler D, Schade M, Zinn C, Cuny C, et al. Multidrug-resistant organisms (MDRO) in rehabilitation clinics in the Rhine-Main-District. Germany. Rehabilitation. 2015;54(5):339–45. https://doi.org/10.1055/s-0035-1559642 (epub 2015 Oct 27. German).
Rollnik JD, Samady AM, Grüter L. Multidrug-resistant germs in neurological early rehabilitation. Rehabilitation. 2014;53(5):346–50. https://doi.org/10.1055/s-0034-1375640 (epub 2014 Oct 15. German).
Gieffers Jens, Ahuja André, Giemulla Ronald. Long term observation of MRSA prevalence in a German rehabilitation center: risk factors and variability of colonization rate. GMS Hyg Infect Control. 2016. https://doi.org/10.3205/dgkh000281 (11:Doc21. Published online).
Köck R, Winner K, Schaumburg F, Jurke A, Rossen JW, Friedrich AW. Admission prevalence and acquisition of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) in German rehabilitation centres. J Hospital Infect. 2014;87(2):115–8. https://doi.org/10.1016/j.jhin.
Varley CD, et al. Persistence of Staphylococcus aureus colonization among individuals with immune-mediated inflammatory diseases treated with TNF-α inhibitor therapy. Rheumatology. 2014;53(2):332–7.
Jain A, Agarwal A, Verma RK. Cefoxitin disc diffusion test for detection of methicillin-resistant staphylococci. J Med Microbiol. 2008;57(Pt 8):957–61.
Bramble M, Morris D, Tolomeo P, Lautenbach E. Potential role of pet animals in household transmission of methicillin-resistant Staphylococcus aureus: a narrative review. Vector Borne Zoonotic Dis. 2011;11(6):617–20 Epub 2010 Dec 13.
Weese JS. Methicillin-resistant Staphylococcus aureus in animals. ILAR J. 2010;51(3):233–44.
Fragen und Antworten zu Methicillin-resistentem Staphylococcus aureus (MRSA) vom Bundesinstitut für Risikobewertung. [Questions and answers about methicillin-resistant Staphylococcus aureus (MRSA) by the Federal Institute for Risk Assessment.] [Internet] 2014 Nov 18. Available from: http://www.bfr.bund.de/de/fragen_und_antworten_zu_methicillin_resistenten_staphylococcus_aureus__mrsa_-11172.html (in German).