The prevalence of methicillin―resistant Staphylococcus aureus colonization in emergency department fast track patients.docVIP

The prevalence of methicillin―resistant Staphylococcus aureus colonization in emergency department fast track patients 　　BACKGROUND： Over the past two decades， methicillin-resistant Staphylococcus aureus （MRSA） has evolved from a hospital-associated infection to a significant public health threat in the community， causing outbreaks of soft tissue infections in otherwise healthy individuals. The goal of this study was to determine the prevalence of nasal MRSA colonization in low acuity Emergency Department （ED） Fast Track patients in order to better characterize the epidemiology of this pathogen. METHODS： We conducted a cross-sectional study of a convenience sample of adult patients from our ED Fast Track. Nasal swabs were analyzed for MRSA using a polymerase chain reaction assay. Study participants completed a survey assessing traditional risk factors for CA-MRSA colonization. RESULTS： A total of 106 ED Fast Track patients were tested. Four （3.8%， 95% CI 1.5%?9.3%） were MRSA positive. Three traditional CA-MRSA risk factors （personal history of abscess， family history of abscess， and participation in contact sports） were examined. In patients with a positive MRSA nasal swab， only a personal prior history of abscess retained significance （OR 33， 95% CI 1.7?676， P=0.02）. CONCLUSION： This study found a higher prevalence of nasal MRSA colonization in low acuity ED Fast Track patients compared with historical community surveillance studies. A personal history of prior abscess was a significant risk for CA-MRSA carriage. KEY WORDS： Methicillin-resistant Staphylococcus aureus； Emergency department World J Emerg Med 2013；4（4）：278?279 DOI： 10.5847/ wjem.j.1920?8642.2013.04.006 INTRODUCTION Methicillin-resistant Staphylococcus aureus （MRSA）， first identified in 1961，[1] was primarily a concern for hospitalized patients until the past two decades when new strains of MRSA emerged in the community.[2] Community-associated MRSA （CA-MRSA） is linked to aggre