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J Clin Med. 2019 May 8;8(5). pii: E631. doi: 10.3390/jcm8050631.

Prevalence and Risk Factors for Positive Nasal Methicillin-Resistant Staphylococcus aureus Carriage Among Orthopedic Patients in Korea.

Author information

1
Department of Orthopedic Surgery, Soonchunhyang University Hospital, College of Medicine, Seoul 04401, Korea. swchoi@schmc.ac.kr.
2
Department of Orthopedic Surgery, Soonchunhyang University Hospital, College of Medicine, Seoul 04401, Korea. jlee@schmc.ac.kr.
3
Department of Orthopedic Surgery, Soonchunhyang University Hospital, College of Medicine, Seoul 04401, Korea. t0152@schmc.ac.kr.
4
Department of Laboratory Medicine, Soonchunhyang University College of Medicine, Seoul 04401, Korea. jkim@schmc.ac.kr.
5
Department of Obstetrics and Gynecology, Bundang CHA Hospital, Seongnam 13496, Korea. goodgood75@naver.com.
6
Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Hospital, College of Medicine, Seoul 04401, Korea. sypark@schmc.ac.kr.
7
Department of Biostatistics, Soonchunhyang University College of Medicine, Seoul 04401, Korea. sue3517@schmc.ac.kr.
8
Department of Orthopedic Surgery, Soonchunhyang University Hospital, College of Medicine, Seoul 04401, Korea. schsbj@schmc.ac.kr.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) causes purulent skin and soft tissue infections as well as other life-threatening diseases. Recent guidelines recommend screening for MRSA at the time of admission. However, few studies have been conducted to determine the prevalence and risk factors for MRSA colonization. A prospective data collection and retrospective analysis was performed. MRSA screening tests were performed using nasal swabs in patients enrolled between January 2017 and July 2018. Demographic data, socio-economic data, medical comorbidities, and other risk factors for MRSA carriage were evaluated among 1577 patients enrolled in the study. The prevalence of MRSA nasal carriage was 7.2%. Univariate regression analysis showed that colonization with MRSA at the time of hospital admission was significantly related to patient age, body mass index, smoking, alcohol, trauma, recent antibiotic use, and route of hospital admission. Multiple logistic regression analysis for the risk factors for positive MRSA nasal carriage showed that being under- or overweight, trauma diagnosis, antibiotic use one month prior to admission, and admission through an emergency department were related to MRSA colonization. This study highlights the importance of a preoperative screening test for patients scheduled to undergo surgery involving implant insertion, particularly those at risk for MRSA.

KEYWORDS:

Methicillin-resistant Staphylococcus aureus (MRSA); infection; nasal screening test; prevalence; risk factors

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results

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