Abstract
Since nosocomial infection with MRSA is common, a preventive system is essential for any hospital dialysis center. This study was undertaken to investigate the annual number of MRSA strains isolated from clinical specimens from 1980 to June 1991 in our surgical ward and dialysis center, and our treatment and system for preventing nosocomial MRSA infection.
Isolated MRSA strains were first detected in 1981 and increased remarkably from 1985 on ward in our surgical ward. One hundred and eighty one strains of MRSA were isolated and 76 cases who developed critical infections. Among hemodialysis patients, an MRSA strain was detected first in a postoperative case in 1989. Cross-infections in the intensive care unit were subsequently recognized in acute renal failure and postoperative hemodialysis patients. After recovery from the critical infections, these patients received maintenance hemodialysis in our dialysis center and continued to have isolated MRSA strains. Intravenous administration of vancomycin for MRSA pneumonia in 3 postoperative hemodialysis patients cured their MRSA pneumonia.
We recommend intravenous administration of vancomycin, which is administered as 1.0 gram a day dose during two days and then in 0.5 gram doses after regular hemodialysis. Our system of prophylaxis against nosocomial infection with MRSA consists of hemodialysis in a private room, a gown technique and sterilization of hands and fingers with a rubbing alcohol sterilizer. Because there has been no evidence of nosocomial MRSA infection in our dialysis center, we are confident that our system is effective in preventing nosocomial MRSA infection in hospital dialysis centers.
