L-1488. Prevalence of and Risk Factors for Colonization with Community-Associated Methicillin - Resistant Staphylococcus Aureus (CA-MRSA) at the Time of Hospital Admission
Session: Poster Session: Community-Acquired MRSA
Sunday, October 26, 2008: 12:00 AM
Room: Hall C
Background: To determine the prevalence, identify risk factors for CA-MRSA colonization among patients presenting for hospital admission.
Methods: In a tertiary teaching hospital, surveillance cultures from the nares, axilla and inguinal areas were performed at the time of admission for all except oncology and hematology patients. Demographics and possible risk factors for colonization were recorded. Antibiotic susceptibility was tested with standard methods and methicillin resistance by the cefoxitin disc method and mec gene detection. Isolates were characterized as CA-MRSA according to their susceptibility pattern. MRSA isolates were tested for Panton-Valentine leukocidin (pvl) gene. Results: Swab samples were collected from 1658 patients in a year. Patients lived in urban areas in 87%, had a mean age of 57 years (median 60) and a female to male ratio of 1.2:1. Staphylococcus aureus was isolated from 249 (15.0%) and MRSA from 43 (2.6%) of the patients (17.2% of colonizing isolates). Detection of colonization was 90.8% in the nares, 39.9% in the axilla and 48.8% in the inguinal area. Among the 43 MRSA isolates, in 39 the susceptibility pattern was consistent with CA-MRSA. 25 of 31 (80%) isolates tested were pvl positive. In the multivariate analysis independent predictors of MRSA colonization were: residence at long-term care facility (LTCF)(p 0.003, OR 8.7) and the presence of skin disease (p=0.001, OR 3.13). Conclusions: Colonization with MRSA of patients admitted to the hospital is low and probably reflects the prevalence of colonization with CA-MRSA in the community. Risk factors for MRSA acquisition do not correlate with previous contact with health-care facilities but with skin diseases (affecting skin integrity) and residence in LTCF.
Anastasia Antoniadou, MD1, Diamantis Plachouras, MD2, Elias Karaiskos3, Fani Pliarchopoulou, MD3, Helen Giamarellou, MD, PhD, Prof4, Irene Galani, PHD5, Konstantinos Protopapas3, Maria Souli, MD, PHD6, Maria Mantzaridou3, Stamatina Tsikrika3 and  A. Antoniadou, None., (1)ATTIKON UNIVERSITY GENERAL HOSPITAL, Athens, Greece, (2)4th Dept of Internal Medicine, Athens, Greece, (3)UNIVERSITY GENERAL HOSPITAL ATTIKON, (4)4th Dept of Internal Medicine, Athens Medical School, Athens, Greece, (5)4th Department of Internal Medicine, University General Hospital Attikon, Chaidari, Greece, (6)4th Department of Internal Medicine, Athens University School of Medicine, Chaidari, Greece


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