title: [Colonization management of methicillin resistant Staphylococcus aureus in patients and health professional in the haemodialysis unit in a situation of high risk of endemic disease: looking for zero nasal carriers?].
abstract: OBJECTIVE
  To describe the dynamics of colonization by methicillin resistant Staphylococcus aureus (MRSA) detected in the Haemodialysis Unit (UHD) of the Hospital San Pedro de Alcantara of Caceres due to the detection of catheter-associated infections. Additionally, we attempt to evaluate the effectiveness of preventive strategies introduced.
  
  
  METHODS
  Nasal swab tests were performed in order to detect MRSA colonization in patients and health professionals from August 2008 to January 2009, according to the Consensus GEIH-SEIMC Y SEMPSPH Consensus. An active surveillance was performed with treatment and control of the carriers until negative results were achieved. A consensus document was drawn up in the UHD with registered preventive measures and work systems were reviewed. Prevalence, cumulative incidence, colonization pressure (carrier ratio per day/total patients or experts per day) were calculated. A chi-square test was performed, as well as a Z test for the comparison ratio.
  
  
  RESULTS
  The nasal swabs of 54 acute and chronic patients on haemodialysis showed an initial carrier prevalence of 29.6%; cumulative incidence in patients of 42.6%. Nasal swabs of 48 professionals had a cumulative incidence of 39.5%. There was a parallel decrease in colonization pressure in patients and specialists. After five months A smear was performed 5 months later on 40 patients and 26 specialists, which showed no carriers among the patients, and one among the health professionals.
  
  
  CONCLUSIONS
  We detected a high number of MRSA carriers among patients and Health professionals from the Haemodialysis Unit. Screening and treatment measures were effective for the decolonization of this population. It is important to adopt long-term strategies for active surveillance for the rapid detection of alert situations.
authors.affiliation: Servicio de Medicina Preventiva, Complejo Hospitalario de Cáceres, Cáceres, España. carmen.gomezg@ses.juntatextremadura.net
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Gómez-González
authors.forename: Rosa
authors.initials: R
authors.lastname: Campos
authors.forename: Javier
authors.initials: J
authors.lastname: Pascua
authors.forename: Nicolas
authors.initials: N
authors.lastname: Marigliano
authors.forename: Jose María
authors.initials: JM
authors.lastname: Lancho
authors.forename: Pilar
authors.initials: P
authors.lastname: Teno
mesh_terms: D000328:Adult; D000465:Algorithms; D058491:Bacterial Load; D002353:Carrier State / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000517:prevention & control*; D004197:Disease Reservoirs; D019353:Endemic Diseases; D005672:Fusidic Acid / Q000627:therapeutic use; D006436:Hemodialysis Units, Hospital; D006801:Humans; D017053:Infection Control; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D016712:Mupirocin / Q000627:therapeutic use; D009296:Nasal Cavity / Q000382:microbiology; D010361:Patients / Q000706:statistics & numerical data*; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D015995:Prevalence; D012306:Risk; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D005672:Fusidic Acid; D016712:Mupirocin