title: Effects of "isolating hemodialysis" on prevention of methicillin-resistant Staphylococcus aureus cross-infection in a hemodialysis unit.
abstract: OBJECTIVE
  To evaluate the effects of a contact isolation program against methicillin-resistant Staphylococcus aureus (MRSA) cross-infection among patients in a hemodialysis unit. CLINICAL SETTING AND METHODS: In all patients maintaining hemodialysis therapy were tested for MRSA infection and who had MRSA infection, not only inpatients but also outpatients were separated into a designated area (isolating hemodialysis). Clinically isolated MRSA strains were clonotyped with coagulase typing, staphylococcal enterotoxin typing and restriction enzyme analysis of plasmid DNA.
  
  
  RESULTS
  The frequency of patients with MRSA infection was 4.5% before starting this protocol and was reduced to 2.9% two and a half years later. At this time, MRSA was isolated from the 8 patients. These 8 clinical strains were differentiated into 6 clonotypes and 3 strains showed the same patterns. Two of 3 were isolated from inpatients and the other was from a patient with community onset MRSA colitis. In this case, most MRSA infections were independent under prophylaxis control and cross-infection was observed only once between hospitalized patients who stayed in a same ward.
  
  
  CONCLUSIONS
  This "isolating hemodialysis" should be useful to prevent cross-infection among patients in end-stage renal disease in a dialysis unit.
authors.affiliation: Department of Nephrology, Kasukabe Shuwa Hospital, Saitama, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Osono
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Kurihara
authors.forename: K
authors.initials: K
authors.lastname: Ohwada
authors.forename: Y
authors.initials: Y
authors.lastname: Sakurai
authors.forename: N
authors.initials: N
authors.lastname: Onoda
authors.forename: M
authors.initials: M
authors.lastname: Takeuchi
authors.forename: H
authors.initials: H
authors.lastname: Yoneshima
authors.forename: N
authors.initials: N
authors.lastname: Hayama
authors.forename: Y
authors.initials: Y
authors.lastname: Iino
authors.forename: M
authors.initials: M
authors.lastname: Saji
authors.forename: R
authors.initials: R
authors.lastname: Shikita
authors.forename: H
authors.initials: H
authors.lastname: Takahashi
authors.forename: H
authors.initials: H
authors.lastname: Ohkuni
mesh_terms: D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D006436:Hemodialysis Units, Hospital; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D006435:Renal Dialysis; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000145:classification / Q000302:isolation & purification; D013997:Time Factors